Individual
BRENDA KINCAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 S. 2ND, STILWELL, OK 74960-3105
(918) 696-6826
(918) 516-0479
Mailing address
15 N 1ST ST, STILWELL, OK 74960-3001
(918) 696-6826
(918) 516-0479
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200556060A
—
OK
Enumeration date
05/28/2015
Last updated
05/28/2015
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