Provider Demographics
NPI:1306444823
Name:SPITLER, KRISTAL ROSE
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:ROSE
Last Name:SPITLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTAL
Other - Middle Name:ROSE
Other - Last Name:KUEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3524 S HUSBAND ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-7538
Mailing Address - Country:US
Mailing Address - Phone:405-338-8531
Mailing Address - Fax:
Practice Address - Street 1:3524 S HUSBAND ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-7538
Practice Address - Country:US
Practice Address - Phone:405-338-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator