Evernorth Direct Health LLC
Organization Active NPI Clinic/Center · Sunnyvale, TX
NPI 1114645819 · NPPES record last updated Aug 18, 2022
Key facts
- NPI
- 1114645819
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- EVERNORTH DIRECT HEALTH LLC
- Practice address
- 199 Planters Rd
Sunnyvale, TX 75182-9601 - Phone
- (972) 203-0266
- Fax
- (972) 203-0222
- NPI assigned
- Aug 18, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- EVERNORTH DIRECT HEALTH LLC
Authorized official
- Name
- Deborah Sue Coolidge
- Title
- Financial Analysis Senior Manager
- Phone
- (623) 277-1170
Corporate family (same tax ID) 8
Practitioners 1
-
Lizy Jimmy Johns, DNP, RN, FNP-BC
National Provider Directory
- Tax ID family
- Evernorth Direct Health LLC
- Part of
- Evernorth Direct Health LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
199 Planters Rd
Sunnyvale, TX 75182-9601
Mailing address
199 Planters Rd
Sunnyvale, TX 75182-9601
Phone (972) 203-0266
Other names
- Mohawk Healthy Life Center Sunnyvale
Other providers in Sunnyvale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.