Doctor Name: | HEATHER PRENTICE |
NPI Number: | 1073983961 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 86291 |
Business Practice Address: | 1502 W 9th St Sulphur, OK - 730862410 |
Business Phone Number: | 5806222351 |
Business Fax Number: | |
Mailing Address: | 1502 W 9th St, SULPHUR |
State: | OK |
Postal Code: | 730862410 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/05/2015 |
NPI Last Update Date: | 10/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WG0000X |
License Number: | 86291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | General Practice |
Taxonomy Definition: |