Waller, Kassie
Waller, Kassie is an sole proprietor health care provider with primary practice located at 1680 S Greathouse Drive , Atoka OK 74525-7452. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Waller, Kassie can be contacted via phone (808) 896-6115.Contact Information
Primary practice address
1680 S Greathouse Drive
Atoka OK 74525-7452
Phone: (808) 896-6115
Fax: (580) 324-4181
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1073241477 |
|---|---|
| LBN Legal business name | Waller, Kassie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 12th, 2022 |
| Last updated | Aug 12th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073241477 | NPPES |
| Oklahoma | MEDICAID | 100683770A |
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