Provider Demographics
NPI:1720567431
Name:HAMILTON, CHRISTA MONE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MONE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 SOUTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-6472
Mailing Address - Country:US
Mailing Address - Phone:918-446-3541
Mailing Address - Fax:
Practice Address - Street 1:4423 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-6472
Practice Address - Country:US
Practice Address - Phone:918-446-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist