Provider Demographics
NPI:1124390703
Name:ALEXANDER, PATRICIA JEAN
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JEAN
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-5050
Mailing Address - Country:US
Mailing Address - Phone:918-758-1930
Mailing Address - Fax:918-758-1920
Practice Address - Street 1:1110 E 133RD ST
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-2330
Practice Address - Country:US
Practice Address - Phone:918-291-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator