Healthcare Provider Details

I. General information

NPI: 1942423074
Provider Name (Legal Business Name): KRISTIANA LEI TRANUM CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 S YALE AVE #400
TULSA OK
74136-1907
US

IV. Provider business mailing address

6151 S YALE AVE #400
TULSA OK
74136-1907
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-8500
  • Fax: 918-307-5578
Mailing address:
  • Phone: 918-494-8500
  • Fax: 918-307-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberR0055337
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: