Healthcare Provider Details

I. General information

NPI: 1346550787
Provider Name (Legal Business Name): MELISSA CRAFT CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/20/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE 10TH ST STE 2300
OKLAHOMA CITY OK
73104-5418
US

IV. Provider business mailing address

1100 N STONEWALL AVE STE 116
OKLAHOMA CITY OK
73117-1200
US

V. Phone/Fax

Practice location:
  • Phone: 405-844-2601
  • Fax: 405-844-2610
Mailing address:
  • Phone: 405-271-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License NumberR0037076
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number37076
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: