Healthcare Provider Details

I. General information

NPI: 1750294062
Provider Name (Legal Business Name): KIRSTI MCKINZI LYNN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 N WASHINGTON ST
WEATHERFORD OK
73096-2443
US

IV. Provider business mailing address

PO BOX 391
BINGER OK
73009-0391
US

V. Phone/Fax

Practice location:
  • Phone: 580-772-2344
  • Fax:
Mailing address:
  • Phone: 405-933-3779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231601
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: