Individual
KRYSTAL K ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12902 E 51ST ST, TULSA, OK 74134-6712
(918) 994-3476
(918) 995-3006
Mailing address
12902 E 51ST ST, TULSA, OK 74134-6712
(918) 994-3476
(918) 995-3006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60513914
WA
363LF0000X
Family Nurse Practitioner
56934
ID
363LF0000X
Family Nurse Practitioner
Primary
R0069713
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201294340A
—
OK
Enumeration date
04/30/2019
Last updated
01/09/2025
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