Provider Demographics
NPI:1811644610
Name:FLORENCE, CHRISTINA DEEANN
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:DEEANN
Last Name:FLORENCE
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 1:6972 S 369TH WEST AVE
Mailing Address - Street 2:
Mailing Address - City:MANNFORD
Mailing Address - State:OK
Mailing Address - Zip Code:74044-7053
Mailing Address - Country:US
Mailing Address - Phone:918-381-9038
Mailing Address - Fax:
Practice Address - Street 1:6972 S 369TH WEST AVE
Practice Address - Street 2:
Practice Address - City:MANNFORD
Practice Address - State:OK
Practice Address - Zip Code:74044-7053
Practice Address - Country:US
Practice Address - Phone:918-381-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator