Provider Demographics
NPI:1619615523
Name:TRINIDAD, MARIA CRISTINA MALAMUG (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA CRISTINA
Middle Name:MALAMUG
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 W DURHAM ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-4068
Mailing Address - Country:US
Mailing Address - Phone:918-984-7649
Mailing Address - Fax:
Practice Address - Street 1:1705 E 19TH ST STE 502
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5416
Practice Address - Country:US
Practice Address - Phone:918-748-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0065652363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care