Healthcare Provider Details

I. General information

NPI: 1710619911
Provider Name (Legal Business Name): PAULINA KARAM ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

16117 MONTAGUE DR
EDMOND OK
73013-9700
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2222
  • Fax:
Mailing address:
  • Phone: 405-822-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberOK-R0126838
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberOK-R0126838
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: