Healthcare Provider Details

I. General information

NPI: 1144029448
Provider Name (Legal Business Name): KYLEE RAELYN RAMIREZ APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 1ST ST
ELK CITY OK
73644-3133
US

IV. Provider business mailing address

1801 W 3RD ST
ELK CITY OK
73644-5145
US

V. Phone/Fax

Practice location:
  • Phone: 580-225-2515
  • Fax: 580-303-5850
Mailing address:
  • Phone: 580-225-2511
  • Fax: 580-303-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222374
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number222374
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: