Dewilde, Raegan

Dewilde, Raegan is an sole proprietor health care provider with primary practice located at 523 E State Rd , Fairview OK 73737-1453. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Dewilde, Raegan can be contacted via phone (580) 227-2585.

Contact Information

Primary practice address
523 E State Rd Fairview OK 73737-1453
Phone: (580) 227-2585
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X

Profile Details

NPI number 1780226084
LBN Legal business name Dewilde, Raegan
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 8th, 2019
Last updated Jun 8th, 2022 - 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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