Healthcare Provider Details

I. General information

NPI: 1376063321
Provider Name (Legal Business Name): MOLLY KAY PARTEE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S OSAGE ST
CALDWELL KS
67022-1650
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 620-845-2516
  • Fax: 620-845-2518
Mailing address:
  • Phone: 620-845-2516
  • Fax: 620-845-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95347
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: