| Organization Name: | ACADIA FAMILY MEDICAL CLINIC L.L.C. |
| NPI Number: | 1710311154 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA A FLOWERETTE (OWNER/PROVIDER) |
| Mailing Address: | 230 E 5th St Pawhuska |
| State: | OK US |
| Postal Code: | 740565204 |
| Phone Number: | 9182879112 |
| Fax Number: | 9182879113 |
| NPI Enumeration Date: | 08/21/2013 |
| NPI Last Update Date: | 05/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 70154 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |