Provider Demographics
NPI:1710645478
Name:AFFINITY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:AFFINITY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:405-410-5675
Mailing Address - Street 1:4401 SE 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-8138
Mailing Address - Country:US
Mailing Address - Phone:405-410-5675
Mailing Address - Fax:
Practice Address - Street 1:736 S MUSTANG RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6777
Practice Address - Country:US
Practice Address - Phone:405-410-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty