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Individual

KRYSTINA LACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
920 STANTON L YOUNG BLVD # WP1140, OKLAHOMA CITY, OK 73104-5036
(405) 271-4351
(405) 271-8695
Mailing address
PO BOX 26901, OKLAHOMA CITY, OK 73126-0901
(405) 271-4351
(405) 271-8695

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
137557
OK
367500000X
Certified Registered Nurse Anesthetist
231115
MA

Other

Enumeration date
04/04/2006
Last updated
10/12/2020
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