Organization
LIFELINE HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTI VICK RN,MSN,APRN,CNP (OWNER/OPERATOR)
(405) 747-4835
Entity
Organization
Contact information
Practice address
704 AZALEA HILL DR, YUKON, OK 73099-6504
(405) 747-4835
(405) 467-4417
Mailing address
704 AZALEA HILL DR, YUKON, OK 73099-6504
(405) 747-4835
(405) 467-4417
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14549721
CAQH
OK
Enumeration date
09/25/2019
Last updated
12/24/2019
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