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Organization

401 MEDICAL CENTER PLLC

Active
Other names
401 Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NANCY E. DENTON APRN-CNP, FNP-BC (OWNER/ APRN)
(918) 316-6369
Entity
Organization

Contact information

Practice address
401 E DOWNING ST, TAHLEQUAH, OK 74464-3015
(918) 316-3764
(918) 398-8982
Mailing address
401 E DOWNING ST, TAHLEQUAH, OK 74464-3015
(918) 316-3764
(918) 398-8982

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013603232
NPI
OK
05
201173250A
OK
Enumeration date
08/22/2023
Last updated
08/24/2023
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