Healthcare Provider Details

I. General information

NPI: 1548700834
Provider Name (Legal Business Name): ACCESS FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 N MAIN ST
EUFAULA OK
74432-1633
US

IV. Provider business mailing address

218 N MAIN ST
EUFAULA OK
74432-1633
US

V. Phone/Fax

Practice location:
  • Phone: 918-689-7705
  • Fax:
Mailing address:
  • Phone: 918-689-7705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberR0052357
License Number StateOK

VIII. Authorized Official

Name: DR. CHRISTIE LYNNE GRIFFIN
Title or Position: FAMILY NURSE PRACTITIONER-CERTIFIED
Credential: DNP, APRN
Phone: 918-689-7705