Organization
THE WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA LILIA PINA APRN, NP-C (NURSE PRACTITIONER)
(918) 734-2362
Entity
Organization
Contact information
Practice address
3562 E 51ST ST, TULSA, OK 74135-3518
(918) 313-7351
Mailing address
3562 E 51ST ST, TULSA, OK 74135-3518
(918) 313-7351
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
88067
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699039883
INDIVIDUAL NPI
—
05
—
200455350A
—
OK
Enumeration date
07/14/2016
Last updated
07/14/2016
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