Provider Information for 1780261651
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HELEN PEARL NASHOBA MALANTA NIMSEY
Sex: Female
NPI: 1780261651
Last Updated: 2024-06-07
Certification Date: 2021-07-23
Certification Date: 2021-07-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1780261651 | ||||||||
| Enumeration Date | 2021-03-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 265 WICHITA DR ANADARKO, OK 73005-3705 United States Phone: 405-933-0043 | Fax: | ||||||||
| Primary Practice Address | 265 WICHITA DR ANADARKO, OK 73005-3705 United States Phone: 405-933-0043 | Fax: | ||||||||
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