Provider Demographics
NPI:1649777400
Name:CULLUM, CRISTI ALAINA (LPN)
Entity Type:Individual
Prefix:
First Name:CRISTI
Middle Name:ALAINA
Last Name:CULLUM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CRISTI
Other - Middle Name:ALAINA
Other - Last Name:SAPCUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2103
Mailing Address - Country:US
Mailing Address - Phone:405-234-8400
Mailing Address - Fax:405-234-8435
Practice Address - Street 1:1801 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2103
Practice Address - Country:US
Practice Address - Phone:405-234-8400
Practice Address - Fax:405-234-8435
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60661164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse