Provider Demographics
NPI:1043965494
Name:FURGESON, CHYNA
Entity Type:Individual
Prefix:
First Name:CHYNA
Middle Name:
Last Name:FURGESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHYNA
Other - Middle Name:
Other - Last Name:BOHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10331 FAIRFAX LN
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7507
Mailing Address - Country:US
Mailing Address - Phone:405-517-8588
Mailing Address - Fax:
Practice Address - Street 1:7777 E US HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-9125
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional