Kristianna Fuentes, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201719 Issued in OK

Practice address

827 E Hubbard Rd
Ponca City, OK 74601-1156

Phone

(580) 762-3217

Fax

(580) 762-3224

NPI assigned

Jan 23, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oklahoma Treatment Services LLC

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1306277082
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1306607676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 E HUBBARD RD",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011156",
            "telephone_number": "580-762-3217",
            "fax_number": "580-762-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 E HUBBARD RD",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011156",
            "telephone_number": "580-762-3217",
            "fax_number": "580-762-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "KRISTIANNA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "201719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FMS Midwest Dialysis Centers, LLC
• William R. Ford, M.D.
• Maggie Frank
• Susan Leigh Fraser
• Lily Rebekah Friedl, OTR/L
• John A Fultz
• Mary E Fultz III
• Heather Dawn Fusselman
• Willow Lee Gahr
• Courtney Gallimore

• Licensed Practical Nurse in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.