Individual
JUSTIN MAXWELL VISITACION FERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT-ACCS
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 577-3048
Mailing address
3909 N COUNTRY CLUB CIR, MUSKOGEE, OK 74403-2324
(918) 520-5292
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
4277
OK
2279C0205X
Critical Care Registered Respiratory Therapist
4277
OK
2279E0002X
Emergency Care Registered Respiratory Therapist
4277
OK
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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