Provider Demographics
NPI:1629963301
Name:EVANS, KRISTI MICHELLE X
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:MICHELLE
Last Name:EVANS
Suffix:X
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 1:20111 ROMAN RD
Mailing Address - Street 2:
Mailing Address - City:HARRAH
Mailing Address - State:OK
Mailing Address - Zip Code:73045-9641
Mailing Address - Country:US
Mailing Address - Phone:661-604-3591
Mailing Address - Fax:661-604-3591
Practice Address - Street 1:20111 ROMAN RD
Practice Address - Street 2:
Practice Address - City:HARRAH
Practice Address - State:OK
Practice Address - Zip Code:73045-9641
Practice Address - Country:US
Practice Address - Phone:661-604-3591
Practice Address - Fax:661-604-3591
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist