1851508915 NPI number — MS. NINA LOU HALLUM ARNP

Table of content: MS. NINA LOU HALLUM ARNP (NPI 1851508915)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851508915 NPI number — MS. NINA LOU HALLUM ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALLUM
Provider First Name:
NINA
Provider Middle Name:
LOU
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HALLUM
Provider Other First Name:
NINA
Provider Other Middle Name:
ROBISON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851508915
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9935 STATE HIGHWAY 28
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUCHA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74342-4033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-253-3479
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
433 SOUTH 9TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-253-4511
Provider Business Practice Location Address Fax Number:
918-253-8419
Provider Enumeration Date:
05/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WW0101X , with the licence number:  0046086 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)