Healthcare Provider Details

I. General information

NPI: 1982325486
Provider Name (Legal Business Name): KHRONIC HELPERZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 09/05/2022
Certification Date: 09/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 NW 43RD ST STE 104
OKLAHOMA CITY OK
73118-5027
US

IV. Provider business mailing address

1415 NW 43RD ST STE 104
OKLAHOMA CITY OK
73118-5027
US

V. Phone/Fax

Practice location:
  • Phone: 844-394-4362
  • Fax: 405-444-3014
Mailing address:
  • Phone: 844-394-4362
  • Fax: 405-444-3014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHANTELL ROBINSON
Title or Position: OWNER
Credential:
Phone: 405-362-6399