Organization
HEALTHCARE STAT OF ANADARKO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN BONILLA APRN (OWNER)
(405) 822-2761
Entity
Organization
Contact information
Practice address
1503 S MISSION ST, SUITE A, ANADARKO, OK 73005-5815
(405) 247-1100
(405) 247-1155
Mailing address
PO BOX 5908, NORMAN, OK 73070-5908
(405) 247-1100
(405) 247-1155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3253
OK
363LF0000X
Family Nurse Practitioner
Primary
97727
OK
Other
Enumeration date
03/22/2016
Last updated
05/18/2016
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