Healthcare Provider Details

I. General information

NPI: 1811567811
Provider Name (Legal Business Name): WHITNEY ROCHELLE KERN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 N ELM PL
BROKEN ARROW OK
74012-1616
US

IV. Provider business mailing address

7423 W 69TH ST N
TULSA OK
74126-4360
US

V. Phone/Fax

Practice location:
  • Phone: 918-258-1955
  • Fax: 918-251-9802
Mailing address:
  • Phone: 918-504-6586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06212493
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: