Individual
CHRISTINA LAN CAOILE WARDHANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4101 PERIMETER CENTER DR, OKLAHOMA CITY, OK 73112-2302
(608) 783-7532
Mailing address
1404 NW 176TH ST, EDMOND, OK 73012-9718
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
210810
OK
163W00000X
Registered Nurse
95099506
CA
363L00000X
Nurse Practitioner
Primary
210810
OK
363L00000X
Nurse Practitioner
95018138
CA
Other
Enumeration date
08/16/2021
Last updated
03/21/2023
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