Provider Demographics
NPI:1447530043
Name:RITTENHOUSE BAKER, KRISTA L (CRNA)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:RITTENHOUSE BAKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:L
Other - Last Name:RITTENHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8801 S 101ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5716
Mailing Address - Country:US
Mailing Address - Phone:918-294-4915
Mailing Address - Fax:918-294-4947
Practice Address - Street 1:8801 S 101ST EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5716
Practice Address - Country:US
Practice Address - Phone:918-294-4915
Practice Address - Fax:918-294-4947
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR82998367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered