Healthcare Provider Details

I. General information

NPI: 1417801390
Provider Name (Legal Business Name): KASSIDY T RINCK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13804 E 88TH ST N
OWASSO OK
74055-2522
US

IV. Provider business mailing address

13804 E 88TH ST N
OWASSO OK
74055-2522
US

V. Phone/Fax

Practice location:
  • Phone: 918-730-2548
  • Fax:
Mailing address:
  • Phone: 918-730-2548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205451
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: