Provider Demographics
NPI:1033182258
Name:SAGER, KRISTI GENE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:GENE
Last Name:SAGER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:KRISTI
Other - Middle Name:GENE
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4623 W KENOSHA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8975
Mailing Address - Country:US
Mailing Address - Phone:918-693-0834
Mailing Address - Fax:
Practice Address - Street 1:4623 W KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8975
Practice Address - Country:US
Practice Address - Phone:918-693-0834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR75262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200064670AMedicaid
OK500522075OtherMEDICARE GROUP PIN
OK500522075OtherMEDICARE GROUP PIN
OK247801601Medicare PIN