Healthcare Provider Details

I. General information

NPI: 1184495285
Provider Name (Legal Business Name): CHRISTI ESANU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTI VANHUSS RN

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 06/20/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 NTH AIRPORT ROAD
WEATHERFORD OK
73096
US

IV. Provider business mailing address

812 E KEE ST
WEATHERFORD OK
73096-4004
US

V. Phone/Fax

Practice location:
  • Phone: 580-375-6326
  • Fax:
Mailing address:
  • Phone: 580-715-0812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0113678
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: