Healthcare Provider Details

I. General information

NPI: 1609781988
Provider Name (Legal Business Name): CASEY RENEE MCKNIGHT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9130 S SHERIDAN RD
TULSA OK
74133-5332
US

IV. Provider business mailing address

8565 E 126TH PL S
BIXBY OK
74008-2900
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-8606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231041
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: