MEDICARE: DR. KRISTA LYNN SKILLINGS PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14360	OK

General Provider Information

NPI Number	:	1124303185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTA LYNN SKILLINGS PHARM D

Provider Business Mailing Address
First Line	:	7406 S 70TH EAST CT
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-3039
Country	:	US
Telephone Number	:	918-712-3250
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 S HARVARD AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135
Country	:	US
Telephone Number	:	918-742-1058
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2011
Last Update Date	:	10/20/2011

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