| My Family Healthcare Llc | |
|
1004 N 19th Ave Bldg 2 Durant OK 74701-3017 | |
| (580) 924-5622 | |
| (580) 745-5060 |
| Full Name | My Family Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1004 N 19th Ave Bldg 2, Durant, Oklahoma |
| Authorized Official Name and Position | Jennifer Renee Nelson (HEALTH CARE PROVIDER) |
| Authorized Official Contact | 5809245622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Family Healthcare Llc 1004 N 19th Ave Bldg 2 Durant OK 74701-3017 Ph: (580) 924-5622 | My Family Healthcare Llc 1004 N 19th Ave Bldg 2 Durant OK 74701-3017 Ph: (580) 924-5622 |
| NPI Number | 1013380385 |
|---|---|
| Provider Enumeration Date | 11/08/2015 |
| Last Update Date | 02/22/2016 |
| Medicare PECOS PAC ID | 6709187628 |
|---|---|
| Medicare Enrollment ID | O20151218001656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013380385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brian S Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295911287 PECOS PAC ID: 0840361374 Enrollment ID: I20080611000275 |
| Provider Name | Kennedy B Decker-walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700014867 PECOS PAC ID: 3072709534 Enrollment ID: I20101123000213 |
| Provider Name | Jennifer R Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154602332 PECOS PAC ID: 2062685902 Enrollment ID: I20111109000442 |
| Provider Name | Mallory Earthman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912660762 PECOS PAC ID: 3476942442 Enrollment ID: I20221027002639 |
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