Healthcare Provider Details

I. General information

NPI: 1427717461
Provider Name (Legal Business Name): PULSE HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 W WILL ROGERS BLVD
CLAREMORE OK
74017-5421
US

IV. Provider business mailing address

1124 W WILL ROGERS BLVD
CLAREMORE OK
74017-5421
US

V. Phone/Fax

Practice location:
  • Phone: 918-322-7400
  • Fax: 918-322-7600
Mailing address:
  • Phone: 918-322-7400
  • Fax: 918-322-7600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE JUSTUS
Title or Position: NURSE PRACTITIONER
Credential: APRN-CNP
Phone: 918-322-7400