Healthcare Provider Details

I. General information

NPI: 1184674392
Provider Name (Legal Business Name): WESTVIEW HEALTH CLINIC, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 HAYES AVE
CLINTON OK
73601-3601
US

IV. Provider business mailing address

3140 HAYES AVE
CLINTON OK
73601-3601
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-1937
  • Fax:
Mailing address:
  • Phone: 580-323-1937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberR0057523
License Number StateOK

VIII. Authorized Official

Name: MRS. KRISTY RENEA BAKER
Title or Position: OWNER/NURSE PRACTITIONER
Credential: ARNP
Phone: 580-323-1937