Provider Demographics
NPI:1023395787
Name:BURDINE, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BURDINE
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 1:214 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:REDBIRD
Mailing Address - State:OK
Mailing Address - Zip Code:74458-5007
Mailing Address - Country:US
Mailing Address - Phone:918-483-1425
Mailing Address - Fax:918-483-1425
Practice Address - Street 1:214 S 4TH ST
Practice Address - Street 2:
Practice Address - City:REDBIRD
Practice Address - State:OK
Practice Address - Zip Code:74458-5007
Practice Address - Country:US
Practice Address - Phone:918-483-1425
Practice Address - Fax:918-483-1425
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator