Individual
JORGE CARDENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
205 S PARK LN, ALTUS, OK 73521-5755
(580) 379-6650
Mailing address
PO BOX 229, VERNON, TX 76385-0229
(940) 886-7222
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
824786
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
135841
OK
Other
Enumeration date
03/06/2020
Last updated
05/13/2020
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