Individual
CRISTI LEA LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2225 N UNION ST, PONCA CITY, OK 74601-1555
(580) 716-9064
Mailing address
1205 BRENTWOOD DR, PONCA CITY, OK 74601-1714
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0078972
OK
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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