Provider Demographics
NPI:1639495211
Name:BEARD, NORMA JEAN (BA, U-CADC)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:BEARD
Suffix:
Gender:F
Credentials:BA, U-CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E OAK AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-3442
Mailing Address - Country:US
Mailing Address - Phone:405-382-1112
Mailing Address - Fax:405-382-5747
Practice Address - Street 1:214 E OAK AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-3442
Practice Address - Country:US
Practice Address - Phone:405-382-1112
Practice Address - Fax:405-382-5747
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program