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NPI 1578104865

NPI 1578104865 : CHRISTINA KLUCZNY APRN-CNM : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1578104865
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINA KLUCZNY APRN-CNM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/08/2019
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    Last Update Date     |    10/08/2019
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Provider Practice Location Address
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    Address Line         |    6161 S YALE AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74136-1902
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    Country              |    US
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    Telephone            |    918-550-2790
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6161 S YALE AVE SAINT FRANCIS XAVIER CONVENT
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74136-1902
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    Country              |    US
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    Telephone            |    918-550-2790
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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        |    367A00000X
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    Taxonomy Name        |    Advanced Practice Midwife
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    License Number       |    132430
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    License Number State |    OK
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