Provider Demographics
NPI:1437224144
Name:MULANAX, KIMBERLY KAYE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KAYE
Last Name:MULANAX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-1453
Mailing Address - Country:US
Mailing Address - Phone:918-789-3146
Mailing Address - Fax:918-789-5650
Practice Address - Street 1:403 REDBUD LN
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016-1453
Practice Address - Country:US
Practice Address - Phone:918-789-3146
Practice Address - Fax:918-789-5650
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0072394363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health