Provider Demographics
NPI:1154692309
Name:ROTHER, JO ANN
Entity type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
Last Name:ROTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 330
Mailing Address - Street 2:RT. 1 BOX 202
Mailing Address - City:CASHION
Mailing Address - State:OK
Mailing Address - Zip Code:73016-0330
Mailing Address - Country:US
Mailing Address - Phone:405-368-5112
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 202
Practice Address - Street 2:
Practice Address - City:CASHION
Practice Address - State:OK
Practice Address - Zip Code:73016-9750
Practice Address - Country:US
Practice Address - Phone:405-368-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator