Healthcare Provider Details

I. General information

NPI: 1134690514
Provider Name (Legal Business Name): KALETHA LYNELL HIGHTOWER APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SW 119TH ST
OKLAHOMA CITY OK
73170-6067
US

IV. Provider business mailing address

701 SW 119TH ST
OKLAHOMA CITY OK
73170-6067
US

V. Phone/Fax

Practice location:
  • Phone: 405-735-3135
  • Fax: 405-676-9204
Mailing address:
  • Phone: 405-735-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number80852
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: