Healthcare Provider Details

I. General information

NPI: 1184274052
Provider Name (Legal Business Name): CHRISSY MARIE LEHEW APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 N MAIN ST
KINGSTON OK
73439-6562
US

IV. Provider business mailing address

610 E 24TH ST
TISHOMINGO OK
73460-3245
US

V. Phone/Fax

Practice location:
  • Phone: 580-564-7885
  • Fax: 580-564-7902
Mailing address:
  • Phone: 580-371-2343
  • Fax: 580-218-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0088816
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: