Healthcare Provider Details

I. General information

NPI: 1689771198
Provider Name (Legal Business Name): KRISTI ANN CABLER DPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTI ANN DILLARD RPH

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 GRANDVIEW
PAWHUSKA OK
74056
US

IV. Provider business mailing address

21771 N 4028 DRIVE
BARTLESVILLE OK
74006
US

V. Phone/Fax

Practice location:
  • Phone: 918-287-4491
  • Fax: 918-287-2347
Mailing address:
  • Phone: 918-335-2703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30446
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: