| Advanced Lifestyle Solutions Pllc | |
|
5252 N Meridian Ave Oklahoma City OK 73112-2178 | |
| (405) 754-5400 | |
| (405) 754-5404 |
| Full Name | Advanced Lifestyle Solutions Pllc |
|---|---|
| Speciality | General Practice |
| Location | 5252 N Meridian Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Rita Pannell (OPERATIONS MANAGER) |
| Authorized Official Contact | 2143106763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Lifestyle Solutions Pllc 1162 Honey Crk New Braunfels TX 78132-3453 Ph: (214) 310-6763 | Advanced Lifestyle Solutions Pllc 5252 N Meridian Ave Oklahoma City OK 73112-2178 Ph: (405) 754-5400 |
| NPI Number | 1164026845 |
|---|---|
| Provider Enumeration Date | 11/24/2020 |
| Last Update Date | 01/10/2022 |
| Medicare PECOS PAC ID | 8224487970 |
|---|---|
| Medicare Enrollment ID | O20240117002491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164026845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | John Nelson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174551923 PECOS PAC ID: 4981624673 Enrollment ID: I20060808000533 |
| Provider Name | Kimberly Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851751119 PECOS PAC ID: 1658651120 Enrollment ID: I20161130000300 |
| Provider Name | Anrea L Winston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053943100 PECOS PAC ID: 4183054927 Enrollment ID: I20200420001413 |
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