Healthcare Provider Details

I. General information

NPI: 1255226734
Provider Name (Legal Business Name): KAREN SUE CRITTENDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HONOR HEIGHTS DR
MUSKOGEE OK
74401-1318
US

IV. Provider business mailing address

208 S SPRAGUE AVE
WAGONER OK
74467-6411
US

V. Phone/Fax

Practice location:
  • Phone: 918-577-3830
  • Fax: 918-577-4808
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0083521
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: