Organization
HEALTHCARE STAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN BONILLA APRN-CNP (OWNER)
(405) 485-9588
Entity
Organization
Contact information
Practice address
821 E VETERANS MEMORIAL HWY, BLANCHARD, OK 73010-9215
(405) 485-9588
Mailing address
2120 OAKMONT DR, BLANCHARD, OK 73010-3579
(405) 623-9233
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
OK
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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