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General NPI Number Information
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NPI Number | 1346650397
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Entity Type | Individual
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Provider Name | KAYTI MOXLEY APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 122 E GRAND AVE
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City | PONCA CITY
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State | OK
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Zip | 74601-5205
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Country | US
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Telephone | 580-302-8270
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Fax | 580-749-5682
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Provider Business Mailing Address
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Address Line | 212 N MAIN ST
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City | FAIRFAX
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State | OK
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Zip | 74637-3023
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Country | US
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Telephone | 918-642-3100
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Fax | 918-642-5639
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0058951
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License Number State | OK
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