Healthcare Provider Details

I. General information

NPI: 1649656190
Provider Name (Legal Business Name): HOTSHOTS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7519 S 49TH WEST AVE
TULSA OK
74131-3402
US

IV. Provider business mailing address

PO BOX 700213
TULSA OK
74170-0213
US

V. Phone/Fax

Practice location:
  • Phone: 918-949-7468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAYLA WARNER
Title or Position: OWNER PROVIDER
Credential:
Phone: 918-740-3199