Providence Family Practice, Pllc
LBN: Providence Family Practice, Pllc
Providence Family Practice, Pllc is an health care organization with primary practice located at 1016 Sw 44Th St Ste 400 , Oklahoma City OK 73109-3617. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty.
Providence Family Practice, Pllc can be contacted via phone (405) 702-9050, or through Williams, Christiana Enanga via phone (405) 816-0053.
Contact Information
Primary practice address
1016 Sw 44Th St Ste 400
Oklahoma City OK 73109-3617
Phone: (405) 702-9050
Fax:
Website:
Authorized official contact:
Name: Williams, Christiana Enanga Nurse Practitioner (NP)
Phone: (405) 816-0053
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | R0058523 | Oklahoma |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R0058523 | Oklahoma |
Profile Details
| NPI number | 1215185491 |
|---|---|
| LBN Legal business name | Providence Family Practice, Pllc |
| DBA Doing business as | |
| Authorized official | Williams, Christiana Enanga Nurse Practitioner (NP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2008 |
| Last updated | Jun 24th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215185491 | NPPES |
| Oklahoma | MEDICAID | 200087300A |
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