Healthcare Provider Details

I. General information

NPI: 1316757370
Provider Name (Legal Business Name): KRISTI WATTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335712 E 998 RD
MEEKER OK
74855-5744
US

IV. Provider business mailing address

335712 E 998 RD
MEEKER OK
74855-5744
US

V. Phone/Fax

Practice location:
  • Phone: 580-579-3487
  • Fax:
Mailing address:
  • Phone: 580-579-3487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number228607
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: