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General NPI Number Information
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NPI Number | 1992347355
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Entity Type | Organization
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Legal Business Name | NEXT LEVEL PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 5930 E 31ST ST
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City | TULSA
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State | OK
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Zip | 74135-5118
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Country | US
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Telephone | 918-982-6398
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Fax | 918-982-6392
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Provider Business Mailing Address
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Address Line | 5930 E 31ST ST STE 500
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City | TULSA
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State | OK
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Zip | 74135-5118
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Country | US
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Telephone | 918-982-6398
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Fax | 918-982-6392
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Authorized Official
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Title or Position | CEO
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Name | MRS. VELISA DAVIS
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Credential | APRN-CNP
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Telephone | 918-982-6398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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