MAIN STREET FAMILY HEALTHCARE NURSE PRACTITIONER CLINIC, LLC


Address: 309 W Main St, Stroud, OK 74079-3611
Phone: 9189870067

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
R0052024 OK Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OK 200121770A 05
OK 2005513360A 05

Office Location

Street Address 309 W MAIN ST
City STROUD
State OK
Zip Code 74079-3611

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083821011 Sac & Fox Nation Clinic/Center Rr 2 Box 247, Stroud, OK 74079-9652 2007-05-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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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
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Competitor

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City STROUD
Zip Code 74079

Improve Information

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Dataset Information

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.

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