Provider Demographics
NPI:1891594560
Name:NURSEPRAC, LLC
Entity type:Organization
Organization Name:NURSEPRAC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIA
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:CHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-NP
Authorized Official - Phone:918-457-9347
Mailing Address - Street 1:7301 N OWASSO EXPY STE M115
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-3481
Mailing Address - Country:US
Mailing Address - Phone:918-973-4574
Mailing Address - Fax:918-398-9243
Practice Address - Street 1:7301 N OWASSO EXPY STE M115
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-3481
Practice Address - Country:US
Practice Address - Phone:918-973-4575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care