Provider Demographics
NPI:1295329795
Name:MCKELLAR, CHRISTA (APRN, CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:MCKELLAR
Suffix:
Gender:F
Credentials:APRN, CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 E 15TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4647
Mailing Address - Country:US
Mailing Address - Phone:405-848-0026
Mailing Address - Fax:405-497-6789
Practice Address - Street 1:1822 E 15TH ST STE A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4647
Practice Address - Country:US
Practice Address - Phone:405-848-0026
Practice Address - Fax:405-497-6789
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily