Healthcare Provider Details

I. General information

NPI: 1760259246
Provider Name (Legal Business Name): KATIE ZUECH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 MOSTELLER DR UNIT 3
OKLAHOMA CITY OK
73112-4640
US

IV. Provider business mailing address

5900 MOSTELLER DR UNIT 3
OKLAHOMA CITY OK
73112-4640
US

V. Phone/Fax

Practice location:
  • Phone: 405-608-8808
  • Fax: 405-832-1089
Mailing address:
  • Phone: 405-608-8808
  • Fax: 405-832-1089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5270
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: