MEDICARE: KATRINA MICHELLE PYLE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	92970	OK
2	363LF0000X	Family Nurse Practitioner	92970	OK
3	363LA2100X	Acute Care Nurse Practitioner	R0092970	OK

General Provider Information

NPI Number	:	1295284032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA MICHELLE PYLE NP

Provider Business Mailing Address
First Line	:	PO BOX 966
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73070-0966
Country	:	US
Telephone Number	:	405-757-0150
Fax Number	:	877-669-0254

Provider Business Practice Location Address
First Line	:	5608 SE 67TH ST STE 106
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-1719
Country	:	US
Telephone Number	:	405-757-0150
Fax Number	:	877-669-0254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2016
Last Update Date	:	12/10/2024

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