Provider Demographics
NPI:1457331985
Name:WEBSTER, KAREN L (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1729
Mailing Address - Country:US
Mailing Address - Phone:580-977-1830
Mailing Address - Fax:580-997-1806
Practice Address - Street 1:2424 E. 21 ST
Practice Address - Street 2:SUITE 320
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114
Practice Address - Country:US
Practice Address - Phone:918-392-4547
Practice Address - Fax:918-392-4555
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00698363A00000X
OK1641363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100344200AMedicaid
OKOK403304Medicare PIN
KSS83343Medicare UPIN