| NPI | 1821515032 |
|---|---|
| Doing Business As | BOULEVARD FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | TINA GAY JOY Family Nurse Practitioner, Provider 405-312-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 77055) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-07-21 |