Provider Demographics
NPI:1801535455
Name:NOA, BILLIE N (RE)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:N
Last Name:NOA
Suffix:
Gender:F
Credentials:RE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 N BROOKLINE AVE # 135D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4289
Mailing Address - Country:US
Mailing Address - Phone:405-820-6590
Mailing Address - Fax:
Practice Address - Street 1:6051 N BROOKLINE AVE # 135D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4289
Practice Address - Country:US
Practice Address - Phone:405-820-6590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRE76374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician