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General NPI Number Information
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NPI Number | 1669236162
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Entity Type | Organization
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Legal Business Name | PEOPLE FIRST HEALTH CARE INC. DBA REACH OUT STREET MEDICINE CLINIC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1800 CANYON PARK CIR STE 401
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City | EDMOND
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State | OK
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Zip | 73013-6631
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Country | US
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Telephone | 405-266-1262
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 CANYON PARK CIR STE 401
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City | EDMOND
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State | OK
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Zip | 73013-6631
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Country | US
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Telephone | 405-266-1262
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Fax |
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Authorized Official
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Title or Position | FOUNDER, EXECUTIVE DIRECTOR
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Name | DR. DEBRA MCCULLOCK
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Credential | APRN
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Telephone | 405-266-1262
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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 |
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License Number State |
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