Provider Demographics
NPI:1578104865
Name:KLUCZNY, CHRISTINA (APRN-CNM)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:KLUCZNY
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:MARIE JOSEPHA
Other - Middle Name:
Other - Last Name:KLUCZNY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6161 S YALE AVE
Mailing Address - Street 2:SAINT FRANCIS XAVIER CONVENT
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-1902
Mailing Address - Country:US
Mailing Address - Phone:918-550-2790
Mailing Address - Fax:
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-550-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK132430367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife