Provider Demographics
NPI:1467863928
Name:INDEPENDENT NURSING
Entity Type:Organization
Organization Name:INDEPENDENT NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:OTOO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-301-6806
Mailing Address - Street 1:2113 NE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-8155
Mailing Address - Country:US
Mailing Address - Phone:405-301-6806
Mailing Address - Fax:
Practice Address - Street 1:2113 NE 2ND ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-8155
Practice Address - Country:US
Practice Address - Phone:405-301-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities