Healthcare Provider Details

I. General information

NPI: 1922586395
Provider Name (Legal Business Name): KRYSTLE NICOLE CIRSTEA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 11/23/2025
Certification Date: 11/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 E FRANK PHILLIPS BLVD
BARTLESVILLE OK
74006-2411
US

IV. Provider business mailing address

15618 E 99TH ST N
OWASSO OK
74055-5257
US

V. Phone/Fax

Practice location:
  • Phone: 313-673-5984
  • Fax:
Mailing address:
  • Phone: 313-673-5984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9310669
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: