Provider Demographics
NPI:1659911469
Name:NORMAN, KHYRSTEE DAVEN
Entity Type:Individual
Prefix:
First Name:KHYRSTEE
Middle Name:DAVEN
Last Name:NORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32746 N 3970 RD
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:OK
Mailing Address - Zip Code:74061-3427
Mailing Address - Country:US
Mailing Address - Phone:918-440-3916
Mailing Address - Fax:
Practice Address - Street 1:700 S PENN AVE
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3847
Practice Address - Country:US
Practice Address - Phone:918-337-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist