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General NPI Number Information
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NPI Number | 1871920777
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST MEDICAL CLINIC APRN-CNP PLLC
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 10/09/2013
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Provider Practice Location Address
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Address Line | 714 W MAIN ST
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City | STIGLER
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State | OK
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Zip | 74462-2338
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Country | US
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Telephone | 918-630-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 714 W MAIN ST
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City | STIGLER
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State | OK
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Zip | 74462-2338
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Country | US
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Telephone | 918-630-6070
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. JULIE A FIORETTI
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Credential | APRN-CNP
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Telephone | 918-448-4018
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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 | 71804
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License Number State | OK
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