MEDICARE: CHRISTINA PHILIP

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	363LF0000X	Family Nurse Practitioner	99956	OK

General Provider Information

NPI Number	:	1417403940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PHILIP

Provider Business Mailing Address
First Line	:	4101 PERIMETER CENTER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2302
Country	:	US
Telephone Number	:	405-702-7753
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 PERIMETER CENTER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2302
Country	:	US
Telephone Number	:	405-702-7750
Fax Number	:

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

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	02/19/2020

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Directions to “ CHRISTINA PHILIP ” Practice Location

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