Provider Demographics
NPI:1932498128
Name:DYE, CHARLENE D
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:D
Last Name:DYE
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 328
Mailing Address - Street 2:
Mailing Address - City:CIMARRON
Mailing Address - State:KS
Mailing Address - Zip Code:67835-0328
Mailing Address - Country:US
Mailing Address - Phone:316-251-1369
Mailing Address - Fax:620-855-2221
Practice Address - Street 1:706 N BIRCH ST
Practice Address - Street 2:
Practice Address - City:CIMARRON
Practice Address - State:KS
Practice Address - Zip Code:67835-0328
Practice Address - Country:US
Practice Address - Phone:316-251-1369
Practice Address - Fax:620-855-2221
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator