Provider Demographics
NPI:1689731069
Name:DYER, CHRISTINE N (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:N
Last Name:DYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11317 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5849
Mailing Address - Country:US
Mailing Address - Phone:405-616-1941
Mailing Address - Fax:405-616-1941
Practice Address - Street 1:11317 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5849
Practice Address - Country:US
Practice Address - Phone:405-616-1941
Practice Address - Fax:405-616-1941
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist