MAIN STREET FAMILY HEALTHCARE NURSE PRACTITIONER CLINIC, LLC (NPI# 1154719169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154719169 |
Entity Type | Organization |
Organization Name | MAIN STREET FAMILY HEALTHCARE NURSE PRACTITIONER CLINIC, LLC |
Practice Address |
309 W Main St Stroud OK 74079-3611 |
Mailing Address |
309 W Main St P.o. Box 968 Stroud OK 74079-3611 |
Practice Telephone | 9189870067 |
Mailing Telephone | 9189870067 |
Enumeration Date | 2014-12-27 |
Last Update Date | 2015-12-18 |
Authorized Official Name | BRONWYN L. HOWARD (OWNER/OPERATOR) |
Authorized Official Telephone | 9189505053 |
Authorized Official Credential | APRN-CNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R0052024 | OK | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 200121770A | 05 | |
OK | 2005513360A | 05 |
Street Address |
309 W MAIN ST |
City | STROUD |
State | OK |
Zip Code | 74079-3611 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649710369 | Daniel Hall | Nurse Practitioner | 2308 Ok-66, Stroud, OK 74079 | 2017-02-28 |
1407106636 | Danita Kollars | Counselor | 256110 E. 930 Rd, Stroud, OK 74079 | 2012-09-14 |
1790798411 | Dental Designs of Stroud | Dentist | 401 W Main, Stroud, OK 74079 | 2006-08-14 |
1720019953 | Fidelity Health Care Consultants, P.C. | Clinic/Center | 320 North 4th Ave., Stroud, OK 74079 | 2006-07-05 |
1205836061 | Thomas Seymour Henry | Internal Medicine | Route 2 Box 247, Black Hawk Health Center, Stroud, OK 74079 | 2005-07-22 |
1275934283 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1600 W Highway 66, Stroud, OK 74079-2804 | 2014-09-09 |
1548603855 | Jennifer Dae Arvizu | Occupational Therapy Assistant | 218 W 5th St, Stroud, OK 74079-3419 | 2013-04-17 |
1073030243 | John Daniel Neal | Counselor | 501 N 1st Ave, Stroud, OK 74079-3446 | 2017-08-28 |
1508999145 | Timothy D Moore Od PC | Optometrist | 109 W Main St, Stroud, OK 74079-3607 | 2007-03-13 |
1417935008 | Timothy Dean Moore | Optometrist | 109 W Main St, Stroud, OK 74079-3607 | 2006-01-04 |
Find all providers in zip 74079 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083821011 | Sac & Fox Nation | Clinic/Center | Rr 2 Box 247, Stroud, OK 74079-9652 | 2007-05-17 |
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1184222705 | Essential Md, Pllc | Clinic/Center | 6316 E 102nd St Ste 100, Tulsa, OK 74137-7061 | 2020-10-15 |
1881292191 | Team Clinic Management Partners LLC | Clinic/Center | 3100 W New Orleans St, Broken Arrow, OK 74011-1468 | 2020-10-09 |
1972115392 | Team Clinic Management Partners LLC | Clinic/Center | 225 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-18 |
1093327413 | Team Clinic Management Partners LLC | Clinic/Center | 301 W New Orleans St, Broken Arrow, OK 74011-2206 | 2020-08-18 |
1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
1750992038 | Team Clinic Management Partners LLC | Clinic/Center | 251 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-11 |
1689285975 | Team Clinic Management Partners LLC | Clinic/Center | 301 E Tucson St, Broken Arrow, OK 74011-7235 | 2020-08-11 |
1417568700 | Team Clinic Management Partners LLC | Clinic/Center | 1351 E Albany St, Broken Arrow, OK 74012-8995 | 2020-08-11 |
1164033569 | Team Clinic Management Partners LLC | Clinic/Center | 6800 E Quincy Pl, Broken Arrow, OK 74014-4523 | 2020-08-11 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.