MEDICARE: KIM MARIE PATTON ARN-P

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	363L00000X	Nurse Practitioner	R0034932	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649386939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM MARIE PATTON ARN-P

Provider Business Mailing Address
First Line	:	8900 SILVER HILL DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3316
Country	:	US
Telephone Number	:	405-557-1200
Fax Number	:	405-557-1977

Provider Business Practice Location Address
First Line	:	4334 NW EXPRESSWAY STE 175
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1574
Country	:	US
Telephone Number	:	405-557-1200
Fax Number	:	405-557-1977

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	03/29/2021

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