Healthcare Provider Details

I. General information

NPI: 1750646568
Provider Name (Legal Business Name): KATHRYN REYNOLDS KEMPH WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN PAIGE REYNOLDS WHNP

II. Dates (important events)

Enumeration Date: 07/08/2012
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 N WESTERN AVE STE 20
OKLAHOMA CITY OK
73118-5261
US

IV. Provider business mailing address

17509 COYOTE PASS DR
EDMOND OK
73012-0603
US

V. Phone/Fax

Practice location:
  • Phone: 405-590-0950
  • Fax:
Mailing address:
  • Phone: 423-276-3582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number222812
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: