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General NPI Number Information
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NPI Number | 1922767631
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Entity Type | Individual
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Provider Name | KRYSTLE RENEE O'DOWD APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 6006 SE ADAMS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8960
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Country | US
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Telephone | 918-331-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 7128 S CANTON AVE
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City | TULSA
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State | OK
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Zip | 74136-6303
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Country | US
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Telephone | 918-695-9294
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 206196
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License Number State | OK
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