| Kim Evans, | |
|
23611 Wolf Valley Rd, Wister, OK 74966-2945 | |
| (918) 839-4695 | |
| Not Available |
| Full Name | Kim Evans |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 23611 Wolf Valley Rd, Wister, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437582145 | NPI | - | NPPES |
| 200497090 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Entity Name | Choctaw Nation Of Oklahoma |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659347623 PECOS PAC ID: 1759294838 Enrollment ID: O20031106000326 |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Evans, 23611 Wolf Valley Rd, Wister, OK 74966-2945 Ph: (918) 839-4695 | Kim Evans, 23611 Wolf Valley Rd, Wister, OK 74966-2945 Ph: (918) 839-4695 |
Misti Kay Roath, Counselor Medicare: Not Enrolled in Medicare Practice Location: 34718 Carpenter Ln, Wister, OK 74966 Phone: 918-839-0751 | |
Karen Benson, MEDLPC UNDERSUPERVIS Counselor Medicare: Not Enrolled in Medicare Practice Location: 34002 Holson Valley Rd, Wister, OK 74966 Phone: 918-649-7246 | |
Marenda Rachelle Singleterry, Counselor Medicare: Not Enrolled in Medicare Practice Location: 44035 Nanny Ridge Dr, Wister, OK 74966 Phone: 918-721-3982 | |
Regina Sue Peck, LPC Counselor Medicare: Medicare Enrolled Practice Location: 23610 Wolf Valley Rd, Wister, OK 74966 Phone: 918-647-1924 |