Basic Information
| Provider Information | |||||||||
| NPI: | 1548700834 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ACCESS FAMILY CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 218 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | EUFAULA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 744321633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186897705 | ||||||||
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| Practice Location | |||||||||
| Address1: | 218 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | EUFAULA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 744321633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186897705 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2017 | ||||||||
| LastUpdateDate: | 03/06/2017 | ||||||||
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| AuthorizedOfficialLastName: | GRIFFIN | ||||||||
| AuthorizedOfficialFirstName: | CHRISTIE | ||||||||
| AuthorizedOfficialMiddleName: | LYNNE | ||||||||
| AuthorizedOfficialTitleorPosition: | FAMILY NURSE PRACTITIONER-CERTIFIED | ||||||||
| AuthorizedOfficialTelephone: | 9186897705 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DNP, APRN | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | R0052357 | OK | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.