Basic Information
| Provider Information | |||||||||
| NPI: | 1154956142 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARRIGER | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | APRN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 803 N FOREMAN | ||||||||
| Address2: | |||||||||
| City: | VINITA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182562261 | ||||||||
| FaxNumber: | 9182562304 | ||||||||
| Practice Location | |||||||||
| Address1: | 803 N FOREMAN | ||||||||
| Address2: | |||||||||
| City: | VINITA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182562261 | ||||||||
| FaxNumber: | 9182562304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2020 | ||||||||
| LastUpdateDate: | 10/04/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 96279 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.