Individual
CRISTIN MICHELLE FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112-4418
(405) 949-3011
Mailing address
1800 HUNTINGTON AVE, NICHOLS HILLS, OK 73116-5505
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
200194
OK
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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