Provider Demographics
NPI:1396515052
Name:HAMBRICK, EMILY H
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:H
Last Name:HAMBRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:H
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:551 S HAMBRICK HILL RD
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-2168
Mailing Address - Country:US
Mailing Address - Phone:405-740-0199
Mailing Address - Fax:
Practice Address - Street 1:551 S HAMBRICK HILL RD
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-2168
Practice Address - Country:US
Practice Address - Phone:405-740-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator