NPI | 1699358317 |
---|---|
Doing Business As | SSM HEALTH HEALTHY LIVING OKC CLINIC |
Entity Type | Organization |
Authorized Contact | CRYSTAL L PENA Provider Enrollment Coordinator 405-272-7452 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
Enumeration Date | 2021-04-30 |
Last Update Date | 2021-04-30 |