Healthcare Provider Details

I. General information

NPI: 1851491807
Provider Name (Legal Business Name): CHRIS LAUREN CARTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 STANTON L YOUNG BLVD # WP1140
OKLAHOMA CITY OK
73104-5036
US

IV. Provider business mailing address

PO BOX 840848
DALLAS TX
75284-0848
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4351
  • Fax: 405-271-8695
Mailing address:
  • Phone: 972-283-1999
  • Fax: 972-233-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0040897
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number40897
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0040897
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: