Provider Demographics
NPI:1366988768
Name:HITCHCOCK, CHRISTOPHER ALAN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WETUMKA
Mailing Address - State:OK
Mailing Address - Zip Code:74883-4015
Mailing Address - Country:US
Mailing Address - Phone:405-452-5400
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WETUMKA
Practice Address - State:OK
Practice Address - Zip Code:74883-4015
Practice Address - Country:US
Practice Address - Phone:405-452-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF0117230363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner