Provider Demographics
NPI:1366279572
Name:R & A FAMILY WELLNESS LLC
Entity type:Organization
Organization Name:R & A FAMILY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:405-375-7935
Mailing Address - Street 1:1001 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:KINGFISHER
Mailing Address - State:OK
Mailing Address - Zip Code:73750-5002
Mailing Address - Country:US
Mailing Address - Phone:405-375-7935
Mailing Address - Fax:405-375-7937
Practice Address - Street 1:1001 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-5002
Practice Address - Country:US
Practice Address - Phone:405-375-7935
Practice Address - Fax:405-375-7937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty