| Destiny Urgent And Primary Care Clinic. Llc | |
|
1818 N Highway 66 Ste B Catoosa OK 74015-3052 | |
| (417) 317-3388 | |
| Not Available |
| Full Name | Destiny Urgent And Primary Care Clinic. Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1818 N Highway 66 Ste B, Catoosa, Oklahoma |
| Authorized Official Name and Position | Ernest Kaara Maina (OWNER/PROVIDER) |
| Authorized Official Contact | 4173173388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Urgent And Primary Care Clinic. Llc 1000 W Elmira St Broken Arrow OK 74012-0872 Ph: (417) 317-3388 | Destiny Urgent And Primary Care Clinic. Llc 1818 N Highway 66 Ste B Catoosa OK 74015-3052 Ph: (417) 317-3388 |
| NPI Number | 1437738804 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 04/22/2021 |
| Medicare PECOS PAC ID | 4082022272 |
|---|---|
| Medicare Enrollment ID | O20210428002414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437738804 | NPI | - | NPPES |
| 1740751445 | Other | OK | NPI# |
| Provider Name | Ernest K Maina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740751445 PECOS PAC ID: 0345573119 Enrollment ID: I20190610002652 |
| Provider Name | Erica M Dees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699360586 PECOS PAC ID: 4587073267 Enrollment ID: I20210510001871 |
| Provider Name | Meagan Kay Meffert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649990722 PECOS PAC ID: 3072986793 Enrollment ID: I20230228002447 |
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