| Mrs Addie Beth Gratz, ARNP | |
|
9 N Main St, Kingston, OK 73439-6562 | |
| (580) 564-0500 | |
| (580) 564-0250 |
| Full Name | Mrs Addie Beth Gratz |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Primary Care |
| Location | 9 N Main St, Kingston, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669498051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | R0067529 (Oklahoma) | Primary |
| Entity Name | Meridian Long Term Care Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164176442 PECOS PAC ID: 2668866260 Enrollment ID: O20220224001659 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Addie Beth Gratz, ARNP Po Box 849, Tishomingo, OK 73460-0849 Ph: (580) 564-0500 | Mrs Addie Beth Gratz, ARNP 9 N Main St, Kingston, OK 73439-6562 Ph: (580) 564-0500 |
Tressa Antionette Matchen, ARNP-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Clinic At 410 Pllc, 410 Hwy 70 Kingston, Ok 73439, Kingston, OK 73439 Phone: 580-565-9975 Fax: 888-241-2340 | |
Toni Mclemore, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 21 N Main St, Kingston, OK 73439 Phone: 580-564-7885 Fax: 580-564-7902 | |
Glenda Gene Cross, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 21 N Main St, Kingston, OK 73439 Phone: 580-564-7885 Fax: 580-564-7902 |