Provider Demographics
NPI:1760477632
Name:SCOGGINS, CHRISTY (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:SCOGGINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 NW CACHE RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3877
Mailing Address - Country:US
Mailing Address - Phone:580-265-8871
Mailing Address - Fax:580-265-8849
Practice Address - Street 1:3414 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3877
Practice Address - Country:US
Practice Address - Phone:580-265-8871
Practice Address - Fax:580-265-8849
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK222057363LF0000X
TN33472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ081031Medicaid
OKMS1286067Medicaid