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General NPI Number Information
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NPI Number | 1548584030
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Entity Type | Individual
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Provider Name | KRISTIN M COLTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 2000 EAST 15TH ST., STE 400 A
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-341-1697
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Fax |
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Provider Business Mailing Address
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Address Line | 18007 TIMBER VALLEY DR
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City | CHOCTAW
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State | OK
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Zip | 73020
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1817
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License Number State | OK
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