# HEALTHCARE STAT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669906806
- **Authorized official:** SHAWN BONILLA APRN-CNP (OWNER)
- **Authorized official phone:** (405) 485-9588

## Contact information

- **Practice address:** 821 E VETERANS MEMORIAL HWY, BLANCHARD, OK 73010-9215
- **Practice address phone:** (405) 485-9588
- **Mailing address:** 2120 OAKMONT DR, BLANCHARD, OK 73010-3579
- **Mailing address phone:** (405) 623-9233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | OK | Yes |

## Other

- **Enumeration date:** 04/14/2017
- **Last updated:** 04/14/2017