Provider Demographics
NPI:1639973118
Name:BRUTON, KRISTEN SEIANNA
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:SEIANNA
Last Name:BRUTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:OK
Mailing Address - Zip Code:74728-5405
Mailing Address - Country:US
Mailing Address - Phone:580-306-6002
Mailing Address - Fax:
Practice Address - Street 1:1020 CRAIG RD
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:OK
Practice Address - Zip Code:74728-5405
Practice Address - Country:US
Practice Address - Phone:580-306-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator