1053658575 NPI number — MS. DANA FRANCIS NOBLES MS, CRC, LPC CANDIDA

Table of content: MS. DANA FRANCIS NOBLES MS, CRC, LPC CANDIDA (NPI 1053658575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053658575 NPI number — MS. DANA FRANCIS NOBLES MS, CRC, LPC CANDIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOBLES
Provider First Name:
DANA
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CRC, LPC CANDIDA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053658575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 673
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALLIANT
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74764-0673
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-933-7031
Provider Business Mailing Address Fax Number:
580-933-7034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 NORTH DALTON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALLIANT
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-933-7031
Provider Business Practice Location Address Fax Number:
580-933-7034
Provider Enumeration Date:
01/04/2013

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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