Organization
CLINICO LLC
Active
Other names
Clinico Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI LEE ELLIS FNP-C (OWNER/ADMINISTRATOR)
(918) 367-0010
Entity
Organization
Contact information
Practice address
103 E MAIN, BEGGS, OK 74421-0478
(918) 267-7000
(918) 267-7077
Mailing address
PO BOX 478, BEGGS, OK 74421-0478
(918) 267-7000
(918) 267-7077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
364SF0001X
Family Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708410B
—
OK
Enumeration date
08/10/2006
Last updated
09/30/2021
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