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General NPI Number Information
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NPI Number | 1477158012
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Entity Type | Individual
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Provider Name | KRISTIE PRICE-SISSONS LPN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 948 W HEFNER RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-6927
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Country | US
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Telephone | 580-334-0558
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Fax |
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Provider Business Mailing Address
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Address Line | 631 SW 37TH ST
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City | MOORE
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State | OK
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Zip | 73160-7746
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Country | US
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Telephone | 580-334-0558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L0052210
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License Number State | OK
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