MEDICARE: ANGELA OELKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	4803	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932510062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA OELKE

Provider Business Mailing Address
First Line	:	110 W BROADWAY STE 202
Second Line	:
City	:	WILLISTON
State	:	ND
Zip	:	58801-6056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W BROADWAY STE 202
Second Line	:
City	:	WILLISTON
State	:	ND
Zip	:	58801-6056
Country	:	US
Telephone Number	:	701-774-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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Directions to “ ANGELA OELKE ” Practice Location

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