Organization
STATHEALTH CLINIC PLLC
Active
Other names
Stathealth Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI LEA SEYMOUR APRN-CNP (OWNER)
(580) 286-1095
Entity
Organization
Contact information
Practice address
805 SE WASHINGTON ST, IDABEL, OK 74745-3331
(580) 286-1095
(580) 286-3122
Mailing address
805 SE WASHINGTON ST, IDABEL, OK 74745-3331
(580) 286-1095
(580) 286-3122
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200344450A
—
OK
Enumeration date
04/26/2011
Last updated
09/16/2024
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