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Organization

HEALTHCARE STAT OF NEWCASTLE LLC

Active
Other names
HEALTHCARE STAT OF NEWCASTLE
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN P BONILLA APRN (OWNER)
(405) 792-0200
Entity
Organization

Contact information

Practice address
2120 N MAIN ST SUITE B, NEWCASTLE, OK 73065
(405) 792-0200
(405) 701-5421
Mailing address
PO BOX 5908, NORMAN, OK 73070-5908
(405) 659-5656
(405) 701-5421

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
68442
OK

Other

Enumeration date
08/28/2016
Last updated
08/28/2016
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