Provider Demographics
NPI:1134742679
Name:ADVOCATE FAMILY HEALTH, LLC
Entity type:Organization
Organization Name:ADVOCATE FAMILY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VAN TREESE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:405-492-7054
Mailing Address - Street 1:2828 NW 57TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7070
Mailing Address - Country:US
Mailing Address - Phone:405-492-7054
Mailing Address - Fax:949-655-2637
Practice Address - Street 1:2828 NW 57TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7070
Practice Address - Country:US
Practice Address - Phone:405-492-7054
Practice Address - Fax:949-655-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care