Churches, Katelynn Jordan
Churches, Katelynn Jordan is an individual health care provider with primary practice located at 118 W Keetoowah St , Tahlequah OK 74464-3820. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Churches, Katelynn Jordan can be contacted via phone (918) 201-4333.Contact Information
Primary practice address
118 W Keetoowah St
Tahlequah OK 74464-3820
Phone: (918) 201-4333
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | Oklahoma |
Profile Details
| NPI number | 1699439604 |
|---|---|
| LBN Legal business name | Churches, Katelynn Jordan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2021 |
| Last updated | Oct 26th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699439604 | NPPES |
| Oklahoma | MEDICAID | 1134704489 |
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