# DESTINY URGENT AND PRIMARY CARE CLINIC. LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437738804
- **Authorized official:** ERNEST KAARA MAINA FNP (OWNER/PROVIDER)
- **Authorized official phone:** (417) 317-3388

## Contact information

- **Practice address:** 1818 N HIGHWAY 66 STE B, CATOOSA, OK 74015-3052
- **Practice address phone:** (417) 317-3388
- **Mailing address:** 1000 W ELMIRA ST, BROKEN ARROW, OK 74012-0872
- **Mailing address phone:** (417) 317-3388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2021
- **Last updated:** 04/22/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1740751445 | NPI\# | OK |