Provider Demographics
NPI:1225094782
Name:MOSLANDER, CHRISTY L (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:L
Last Name:MOSLANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CHRISTY
Other - Middle Name:L
Other - Last Name:CERMAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 W LINDSEY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4108
Mailing Address - Country:US
Mailing Address - Phone:405-360-1556
Mailing Address - Fax:405-360-2830
Practice Address - Street 1:2100 W LINDSEY ST
Practice Address - Street 2:SUITE B
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4108
Practice Address - Country:US
Practice Address - Phone:405-360-1556
Practice Address - Fax:405-360-2830
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR96285363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0941Medicaid
SCNP0941Medicaid
Q57749Medicare UPIN