Provider Demographics
NPI:1285197087
Name:LEGGINS, HERLENA PAMELA (MED)
Entity Type:Individual
Prefix:
First Name:HERLENA
Middle Name:PAMELA
Last Name:LEGGINS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 SPRINGLAKE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-5109
Mailing Address - Country:US
Mailing Address - Phone:405-470-1121
Mailing Address - Fax:
Practice Address - Street 1:4133 SPRINGLAKE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5109
Practice Address - Country:US
Practice Address - Phone:405-740-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator