Provider Demographics
NPI:1235977224
Name:STANFIELD, CHRISTY NANETTE (MS, RN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:NANETTE
Last Name:STANFIELD
Suffix:
Gender:F
Credentials:MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 LICK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:OK
Mailing Address - Zip Code:74561-5084
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 HONOR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-1318
Practice Address - Country:US
Practice Address - Phone:918-577-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0059773163WC0400X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase Management