Provider Demographics
NPI:1770815748
Name:KREBS, KRISTI A (PA)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:A
Last Name:KREBS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:BEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6802 S OLYMPIA AVE STE 275
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1848
Mailing Address - Country:US
Mailing Address - Phone:918-600-0327
Mailing Address - Fax:918-732-9229
Practice Address - Street 1:6802 S OLYMPIA AVE STE 275
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1848
Practice Address - Country:US
Practice Address - Phone:918-600-0327
Practice Address - Fax:918-732-9229
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200642510Medicaid
OK1N6489OtherRAILROAD MEDICARE
OKKRISTIK1OtherCAQH