LESLIE WATKINS BROKEN BOW FAMILY CLINIC LLC (NPI# 1902426489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902426489 |
| Entity Type | Organization |
| Organization Name | LESLIE WATKINS BROKEN BOW FAMILY CLINIC LLC |
| Practice Address |
410 S Park Dr Broken Bow OK 74728-4742 |
| Practice Telephone | 5805846888 |
| Practice Fax Number | 5805846300 |
| Mailing Telephone | 5805846888 |
| Mailing Fax Number | 5805846300 |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | LAUREN DAWN RAGLAND (OFFICE MANAGER) |
| Authorized Official Telephone | 5802120303 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
Nursing Service Providers |
| Street Address |
410 S PARK DR |
| City | BROKEN BOW |
| State | OK |
| Zip Code | 74728-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588204465 | Leslie Orr Watkins | Registered Nurse | 410 S Park Dr, Broken Bow, OK 74728-4742 | 2020-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730732926 | Natorrie D'atra Morris | Nurse Practitioner | Mccurtain Family Medical Clinic, 800 N Park Dr, Broken Bow, OK 74728 | 2019-07-17 |
| 1477925535 | Rebecca Stover | Nurse Practitioner | 813 Veterans Way, Broken Bow, OK 74728 | 2015-10-28 |
| 1023366614 | Tlc Family Clinic, LLC | Clinic/Center | 700 W. Jones, Tlc Family Clinic, LLC, Broken Bow, OK 74728 | 2012-08-29 |
| 1699925867 | Faith Lucille Phillips | Psychologist | 411 S. Park Drive, Broken Bow, OK 74728 | 2008-09-24 |
| 1265057251 | Heather Renee Payne | Counselor | 205 N. Main St, Broken Bow, OK 74728 | 2020-06-15 |
| 1396244109 | Erika Ann White | Counselor | 205 N Main St, Broken Bow, OK 74728 | 2018-02-07 |
| 1366954661 | Black Oak Clinic LLC | Clinic/Center | 110 W 1st St, Broken Bow, OK 74728 | 2017-10-26 |
| 1922467505 | Stover Family Clinic | Clinic/Center | 813 Veterans Way, Broken Bow, OK 74728 | 2016-02-11 |
| 1568820140 | Megan Elizabeth Black | Nurse Practitioner | 110 W 1st St, Broken Bow, OK 74728 | 2016-02-10 |
| 1578797221 | Kenneth G Ericksen | Chiropractor | 1605 S Park Dr, Broken Bow, OK 74728 | 2009-05-11 |
| Find all providers in zip 74728 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261483 | Bejoy Kurian | Registered Nurse | 444 Cactus Rd, Yukon, OK 73099-6852 | 2020-09-24 |
| 1336766112 | Jordan Lynel Meyers | Registered Nurse | 3420 Northview Dr, Beggs, OK 74421-2343 | 2020-06-29 |
| 1255976296 | Joyce Daniel | Registered Nurse | 1350 County Rd 90, Tonkawa, OK 74653-4414 | 2019-11-13 |
| 1407407067 | Julia Francis | Registered Nurse | 6717 Bear Canyon Dr, Oklahoma City, OK 73162-6721 | 2019-09-25 |
| 1821654260 | Genevieve Kathleen Darwiche | Registered Nurse | 1300 S Aries Rd, Edmond, OK 73003-5820 | 2019-05-10 |
| 1801378641 | Tara Ladawn Phillips | Registered Nurse | 410 Moonlight St, Idabel, OK 74745-8108 | 2018-08-29 |
| 1366931396 | Kathy Diane Short | Registered Nurse | 229 E Meade Dr, Yukon, OK 73099-5749 | 2018-05-04 |
| 1124536388 | Jacqueline Ann Yarbrough | Registered Nurse | 4488 Nw 257th St, Indiahoma, OK 73552-3230 | 2018-01-22 |
| 1841729241 | Yoyma Pedroso Lopez | Registered Nurse | 4521 192nd Ave Se, Noble, OK 73068 | 2017-06-08 |
| 1497083612 | Diana Kathleen Schaeffer | Registered Nurse | 5809 Nw 103rd Pl, Oklahoma City, OK 73162-6969 | 2009-11-29 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN BOW |
| Zip Code | 74728 |
Please comment or provide details below to improve the information on LESLIE WATKINS BROKEN BOW FAMILY CLINIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.