Provider Demographics
NPI:1528371788
Name:ESTES, LAMONA KAYE (RN/CEO)
Entity Type:Individual
Prefix:
First Name:LAMONA
Middle Name:KAYE
Last Name:ESTES
Suffix:
Gender:F
Credentials:RN/CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 SOUTH B STREET
Mailing Address - Street 2:PO BOX 388
Mailing Address - City:CROWDER
Mailing Address - State:OK
Mailing Address - Zip Code:74430
Mailing Address - Country:US
Mailing Address - Phone:918-334-5580
Mailing Address - Fax:918-334-5581
Practice Address - Street 1:446 SOUTH B STREET
Practice Address - Street 2:
Practice Address - City:CROWDER
Practice Address - State:OK
Practice Address - Zip Code:74430
Practice Address - Country:US
Practice Address - Phone:918-334-5580
Practice Address - Fax:918-334-5581
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK000163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health