# WOMENS HEALTH & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. MARY PHYSICIAN ASSOCIATES, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770571598
- **Legal business name:** ST. MARY PHYSICIAN ASSOCIATES, LLC
- **Authorized official:** MS. JACQUELINE GIBSON-BURRIS CPC (PRACTICE MANAGEMENT MANAGER)
- **Authorized official phone:** (580) 249-3706

## Contact information

- **Practice address:** 615 E OKLAHOMA AVE, SUITE 203, ENID, OK 73701-5951
- **Practice address phone:** (580) 242-3870
- **Practice address fax:** (580) 242-4046
- **Mailing address:** 615 E OKLAHOMA AVE, SUITE 203, ENID, OK 73701-5951
- **Mailing address phone:** (580) 242-3870
- **Mailing address fax:** (580) 242-4046

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 8721 | OK | Yes |
| 207VG0400X | Gynecology Physician | 11867 | OK | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | R0048498 | OK | — |

## Other

- **Enumeration date:** 10/06/2005
- **Last updated:** 02/21/2011