Healthcare Provider Details

I. General information

NPI: 1710031042
Provider Name (Legal Business Name): CAROLYN CLIFTON TESTI MS CNS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EVERETT DR 7TH FLOOR NORTH PAVILION
OKLAHOMA CITY OK
73104-5047
US

IV. Provider business mailing address

1200 EVERETT DR 7TH FLOOR NORTH PAVILION
OKLAHOMA CITY OK
73104-5047
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-5215
  • Fax:
Mailing address:
  • Phone: 405-271-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberR0039119
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: