1124011242 NPI number — MRS. LAURA JEAN STRICKLAND APRN

Table of content: MRS. LAURA JEAN STRICKLAND APRN (NPI 1124011242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124011242 NPI number — MRS. LAURA JEAN STRICKLAND APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRICKLAND
Provider First Name:
LAURA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HALLACY
Provider Other First Name:
LAURA
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124011242
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26300 S HIGHWAY 125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AFTON
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74331-6282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
182-578-5859
Provider Business Mailing Address Fax Number:
918-257-8560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26300 S HIGHWAY 125
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AFTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74331-6282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
182-578-5859
Provider Business Practice Location Address Fax Number:
918-257-8560
Provider Enumeration Date:
08/24/2005

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: 363LF0000X , with the licence number:  R0072294 , 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)