Henry, Destany

Henry, Destany is an sole proprietor health care provider with primary practice located at 1680 S Greathouse Drive , Atoka OK 74525. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Henry, Destany can be contacted via phone (580) 579-0743.

Contact Information

Primary practice address
1680 S Greathouse Drive Atoka OK 74525
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1730792904
LBN Legal business name Henry, Destany
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 27th, 2020
Last updated Aug 27th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730792904 NPPES
Oklahoma MEDICAID 100683770A

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