Provider Demographics
NPI:1154088839
Name:RED RIVER VALLEY HEALTH PLLC
Entity Type:Organization
Organization Name:RED RIVER VALLEY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:405-568-5055
Mailing Address - Street 1:11530 RIDGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:THACKERVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:73459-9623
Mailing Address - Country:US
Mailing Address - Phone:580-276-9066
Mailing Address - Fax:580-276-9063
Practice Address - Street 1:11530 RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:THACKERVILLE
Practice Address - State:OK
Practice Address - Zip Code:73459-9623
Practice Address - Country:US
Practice Address - Phone:580-276-9066
Practice Address - Fax:580-276-9063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty