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General NPI Number Information
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NPI Number | 1063289122
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Entity Type | Organization
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Legal Business Name | KCT HEALTH CARE PLLC
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 5555 E 71ST ST STE 7250
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City | TULSA
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State | OK
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Zip | 74136-6554
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Country | US
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Telephone | 918-492-8301
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Fax |
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Provider Business Mailing Address
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Address Line | 4211 W 84TH ST
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City | TULSA
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State | OK
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Zip | 74132-3032
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Country | US
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Telephone | 479-209-6400
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER/NURSE PRACTITIONER
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Name | KATY ERIN TROTTER
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Credential | APRN-CNP
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Telephone | 479-209-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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