Individual
MRS. KRISTEN BOMBOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN CNP
Contact information
Practice address
2010 BOREN BLVD, SEMINOLE, OK 74868-2050
(405) 382-4507
(405) 382-5269
Mailing address
2010 BOREN BLVD, SEMINOLE, OK 74868-2050
(405) 382-4507
(405) 382-5269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
N5739001
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019070A
—
OK
Enumeration date
06/21/2006
Last updated
09/23/2015
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