Healthcare Provider Details

I. General information

NPI: 1134973274
Provider Name (Legal Business Name): KATHERINE PICKOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 E 31ST ST
TULSA OK
74135-5076
US

IV. Provider business mailing address

1515 W BOWEN PL
TULSA OK
74127-8530
US

V. Phone/Fax

Practice location:
  • Phone: 918-437-9495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: