Healthcare Provider Details

I. General information

NPI: 1538788393
Provider Name (Legal Business Name): CHRISTINE MAYAKO REITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3366 NW EXPRESSWAY STE 660
OKLAHOMA CITY OK
73112-4416
US

IV. Provider business mailing address

3001 QUAIL SPRINGS PKWY FL 5
OKLAHOMA CITY OK
73134-2640
US

V. Phone/Fax

Practice location:
  • Phone: 405-947-3345
  • Fax: 405-949-0849
Mailing address:
  • Phone: 405-947-3345
  • Fax: 405-949-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR0110294
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: