Healthcare Provider Details

I. General information

NPI: 1972542132
Provider Name (Legal Business Name): KATHRYN ANN PERRY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

8008 N 154TH EAST AVE
OWASSO OK
74055-7326
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-2200
  • Fax:
Mailing address:
  • Phone: 918-272-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberR0048483
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: