Provider Demographics
NPI:1013205236
Name:LARNEY- MCCARROLL, BRITTNEY DAWN
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:DAWN
Last Name:LARNEY- MCCARROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:
Mailing Address - City:DEWAR
Mailing Address - State:OK
Mailing Address - Zip Code:74431-0631
Mailing Address - Country:US
Mailing Address - Phone:918-319-1946
Mailing Address - Fax:
Practice Address - Street 1:1803 S WOOD DR
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6825
Practice Address - Country:US
Practice Address - Phone:918-756-9250
Practice Address - Fax:918-756-9187
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist