1942423074 NPI number — MRS. KRISTIANA LEI TRANUM CNS

Table of content: MRS. KRISTIANA LEI TRANUM CNS (NPI 1942423074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942423074 NPI number — MRS. KRISTIANA LEI TRANUM CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRANUM
Provider First Name:
KRISTIANA
Provider Middle Name:
LEI
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942423074
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6151 S YALE AVE
Provider Second Line Business Mailing Address:
#400
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74136-1907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-494-8500
Provider Business Mailing Address Fax Number:
918-307-5578

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6151 S YALE AVE
Provider Second Line Business Practice Location Address:
#400
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-1907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-494-8500
Provider Business Practice Location Address Fax Number:
918-307-5578
Provider Enumeration Date:
04/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SA2100X , with the licence number:  R0055337 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)