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Vivian Tadlock
Case Management Registered Nurse in Prague, Oklahoma
NPI 1659901874

Vivian Tadlock is a Case Management Registered Nurse based in Prague, OK and is specialized in Case Management. Vivian Tadlock practices in Prague, OK. The NPI Number for Vivian Tadlock is 1659901874 and holds a License No. 50524 (Oklahoma).

The current practice location address for Vivian Tadlock is 57533 Moccasin Trail Rd, Prague, OK and can be reached out via phone at 405-567-0054.

Location: 57533 Moccasin Trail Rd, Prague, OK, 74864-1143
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659901874
Provider Name
Vivian Tadlock
Credential
Provider Entity Type
Individual
Gender
Female
Address
57533 Moccasin Trail Rd, Prague, OK, 74864-1143
Phone Number
405-567-0054
Fax Number
Provider Enumeration Date
01/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
57533 Moccasin Trail Rd
City
Prague
State
Oklahoma
Zip
74864-1143
Phone Number
405-567-0054
Fax Number
person
Provider Business Mailing Address Details
Address
57533 Moccasin Trail Rd
City
Prague
State
Oklahoma
Zip
74864-1143
Phone Number
405-567-0054
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Case Management
Taxonomy
163WC0400X
License No.
50524 (Oklahoma)
Definition
Definition to come...
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