Provider Demographics
NPI:1376816645
Name:DILBECK, CLAUDIA JO (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:JO
Last Name:DILBECK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SPRING VLG
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74604-5135
Mailing Address - Country:US
Mailing Address - Phone:918-213-5234
Mailing Address - Fax:
Practice Address - Street 1:11 SPRING VLG
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74604-5135
Practice Address - Country:US
Practice Address - Phone:918-213-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0038544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse