Provider Demographics
NPI:1033733225
Name:MATTIX, KRISTIE NICOLE (DNP)
Entity Type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:NICOLE
Last Name:MATTIX
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 E FRANK PHILLIPS BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2405
Mailing Address - Country:US
Mailing Address - Phone:918-331-2415
Mailing Address - Fax:918-331-2551
Practice Address - Street 1:3400 E FRANK PHILLIPS BLVD STE 501
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2405
Practice Address - Country:US
Practice Address - Phone:918-331-2415
Practice Address - Fax:918-331-2551
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK89898163WM0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn