Provider Demographics
NPI:1205344769
Name:SWADER, KRIS ANNETTE
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:ANNETTE
Last Name:SWADER
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 1:500 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:OK
Mailing Address - Zip Code:73030-3108
Mailing Address - Country:US
Mailing Address - Phone:580-768-1645
Mailing Address - Fax:
Practice Address - Street 1:500 S 2ND ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:OK
Practice Address - Zip Code:73030-3108
Practice Address - Country:US
Practice Address - Phone:580-768-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist