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Contact Information

NICOLE L CUPP, DPM
226 SE DEBELL AVE
BARTLESVILLE, OK74006-2343
 Phone: 918-876-0476
 Fax: 918-876-0479
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NICOLE L CUPP · (Female)

NPI Number 1619298346
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/16/2010
Last updated 03/25/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 301
  • OK Medicaid 200526540A
Hospital affiliation(s)
  • JANE PHILLIPS MEDICAL CENTER - (Acute Care)
    3500 EAST FRANK PHILLIPS BOULEVARD
    BARTLESVILLE, OK 74006
  • ST JOHN OWASSO - (Acute Care)
    12451 EAST 100TH STREET NORTH
    OWASSO, OK 74055
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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