Organization
THEHEALTHWORXLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MICHELLE RENEE STURDIVANT NP (CEO/OWNER)
(405) 695-1187
Entity
Organization
Contact information
Practice address
1425 S SANTA FE AVE STE G, EDMOND, OK 73003-5910
(405) 695-1187
Mailing address
1425 S SANTA FE AVE STE G, EDMOND, OK 73003-5910
(405) 695-1187
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13967262
CAQH
OK
Enumeration date
04/27/2019
Last updated
04/27/2019
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