Organization
OKLAHOMA INTEGRATED CARE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA PRESTON APRN (NURSE PRACTITIONER)
(580) 504-1517
Entity
Organization
Contact information
Practice address
1013 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 504-1517
Mailing address
1013 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 238-4277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
163W00000X
Registered Nurse
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/19/2020
Last updated
07/30/2024
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