Healthcare Provider Details

I. General information

NPI: 1487580494
Provider Name (Legal Business Name): KRISTINA HENSON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 S UTICA AVE STE 300
TULSA OK
74104-4243
US

IV. Provider business mailing address

1265 S UTICA AVE STE 300
TULSA OK
74104-4243
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number204421
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: