Individual
DR. NICOLE LYNN CUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
226 SE DEBELL AVE, BARTLESVILLE, OK 74006-2343
(918) 876-0476
(918) 876-0479
Mailing address
226 SE DEBELL AVE, BARTLESVILLE, OK 74006-2343
(918) 876-0476
(918) 876-0479
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
301
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200526540A
—
OK
Enumeration date
06/16/2010
Last updated
03/25/2016
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