Provider Demographics
NPI:1134967797
Name:HOLIATRY HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:HOLIATRY HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:918-719-2841
Mailing Address - Street 1:323 E ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-1205
Mailing Address - Country:US
Mailing Address - Phone:918-719-2841
Mailing Address - Fax:918-398-9238
Practice Address - Street 1:323 E ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-1205
Practice Address - Country:US
Practice Address - Phone:918-719-2841
Practice Address - Fax:918-398-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty