Healthcare Provider Details

I. General information

NPI: 1922498476
Provider Name (Legal Business Name): KRYSTON LEAH SALSMAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 N BIRCH AVE
BROKEN ARROW OK
74012-2690
US

IV. Provider business mailing address

1215 N BIRCH AVE
BROKEN ARROW OK
74012-2690
US

V. Phone/Fax

Practice location:
  • Phone: 918-960-0926
  • Fax: 833-764-3806
Mailing address:
  • Phone: 918-960-0926
  • Fax: 833-764-3806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number98986
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: