Provider Demographics
NPI:1821499336
Name:DAVIS, CHRISTY LYNN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LYNN
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 S UTICA AVE STE 2123
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4012
Mailing Address - Country:US
Mailing Address - Phone:918-579-5402
Mailing Address - Fax:918-579-5404
Practice Address - Street 1:1120 S UTICA AVE STE 2123
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4012
Practice Address - Country:US
Practice Address - Phone:918-579-5402
Practice Address - Fax:918-579-5404
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018009258363LN0000X
ARR66633363LN0000X
OKR0112502363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal