Provider Demographics
NPI:1497454151
Name:MIKEL, OLIVIA MARIE
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARIE
Last Name:MIKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 BENT TREE RD
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-9354
Mailing Address - Country:US
Mailing Address - Phone:405-659-0202
Mailing Address - Fax:
Practice Address - Street 1:1016 SW 44TH ST STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3615
Practice Address - Country:US
Practice Address - Phone:405-605-4249
Practice Address - Fax:405-605-0255
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator