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General NPI Number Information
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NPI Number | 1659597706
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Entity Type | Organization
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Legal Business Name | SAM HIDER COMMUNITY CLINIC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1015 WASHBURN
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City | JAY
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State | OK
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Zip | 74346
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Country | US
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Telephone | 918-253-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 33396 S 550 RD
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City | JAY
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State | OK
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Zip | 74346-5478
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Country | US
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Telephone | 918-787-6593
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | PATRICIA A POSTIER
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Credential | ARNP
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Telephone | 918-253-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0068852
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License Number State | OK
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