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General NPI Number Information
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NPI Number | 1710645478
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Entity Type | Organization
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Legal Business Name | AFFINITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 736 S MUSTANG RD
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City | YUKON
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State | OK
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Zip | 73099-6777
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Country | US
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Telephone | 405-410-5675
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 SE 37TH ST
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City | NORMAN
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State | OK
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Zip | 73071-8138
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Country | US
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Telephone | 405-410-5675
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Fax |
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | MRS. MISTY DAWN DEAN
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Credential | APRN
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Telephone | 405-410-5675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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