Healthcare Provider Details

I. General information

NPI: 1144269671
Provider Name (Legal Business Name): CHRIS PARKS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N 9TH AVE
PURCELL OK
73080-1741
US

IV. Provider business mailing address

PO BOX 893244
OKLAHOMA CITY OK
73189-3244
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-6524
  • Fax:
Mailing address:
  • Phone: 405-259-4149
  • Fax: 918-461-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR0029229
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberR2029229
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: