Individual
MISS KRISTA NICOLE HAVENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N CHOCTAW, SUITE 140, EL RENO, OK 73036-2624
(405) 262-3209
(405) 262-1331
Mailing address
200 N CHOCTAW AVE, SUITE 140, EL RENO, OK 73036-2624
(405) 262-3203
(405) 262-1331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/10/2007
Last updated
10/10/2007
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