Provider Demographics
NPI:1538668694
Name:HEARON, CHRISTA LEANNE
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:LEANNE
Last Name:HEARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:LEANNE
Other - Last Name:CHATMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 QUEENSBORO PL
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5429
Mailing Address - Country:US
Mailing Address - Phone:405-408-7106
Mailing Address - Fax:
Practice Address - Street 1:4300 N LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-5107
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator