Choctaw Womens Clinic PLLC
Nurse Practitioner, Family in Choctaw, OK. Organization (NPI-2).
NPI number1194134726
StatusActive
Last updated in NPPESAug 7, 2014
Details
- NPI
- 1194134726
- Entity type
- Organization (NPI-2)
- Legal business name
- Choctaw Womens Clinic PLLC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2014
- Last updated
- Aug 7, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
14890 Se 29th StSuite 106
Choctaw, OK 73020-3515
Phone 405-620-0049 · Fax 405-234-9476
Mailing address
14890 Se 29th StreetSuite 106
Choctaw, OK 73020
Phone 405-620-0049 · Fax 405-234-9476
Authorized official
Sara Marie Botchlet
Owner
4056200049
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