Provider Demographics
NPI:1306008107
Name:LITTLE TREE MEDICAL CLINIC
Entity Type:Organization
Organization Name:LITTLE TREE MEDICAL CLINIC
Other - Org Name:LITTLETREE NURSE PRACTITIONER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIPPY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:918-352-9001
Mailing Address - Street 1:900 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-6200
Mailing Address - Country:US
Mailing Address - Phone:918-352-9194
Mailing Address - Fax:
Practice Address - Street 1:900 W BYPASS
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030-6200
Practice Address - Country:US
Practice Address - Phone:918-352-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0034063261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care