Provider Demographics
NPI:1245433895
Name:PARDUE, MARIE LINDSAY (BSN, RN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:LINDSAY
Last Name:PARDUE
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:BOSWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74727-0271
Mailing Address - Country:US
Mailing Address - Phone:580-566-1271
Mailing Address - Fax:
Practice Address - Street 1:104 N 4TH ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-4003
Practice Address - Country:US
Practice Address - Phone:580-326-7531
Practice Address - Fax:580-326-2377
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0083092163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health