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NPI Code Detail

MEDICARE: CHRISTY L TULLIS LPN

MEDICARE: CHRISTY L TULLIS LPN
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
1164W00000XLicensed Practical NurseL0043635OK

General Provider Information

NPI Number : 1154908689
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY L TULLIS LPN
Provider Business Mailing Address
First Line : 948 W HEFNER RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73114-6927
Country : US
Telephone Number : 405-286-9533
Fax Number : 405-607-0927
Provider Business Practice Location Address
First Line : 948 W HEFNER RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73114-6927
Country : US
Telephone Number : 405-286-9533
Fax Number : 405-607-0927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2021
Last Update Date : 03/29/2021

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Directions to “ CHRISTY L TULLIS LPN” Practice Location

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