Healthcare Provider Details

I. General information

NPI: 1922015239
Provider Name (Legal Business Name): KALA R HATCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALA R HATCH DC

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberMO115172
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115172
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR089609
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1524
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: