| NPI | 1346796604 |
|---|---|
| Doing Business As | HEALTHCARE STAT OF NEWCASTLE |
| Entity Type | Organization |
| Authorized Contact | SHAWN P BONILLA Owner 405-792-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 68442) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |