Provider Demographics
NPI:1497484760
Name:RAWLINS, KEYANNA RENEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KEYANNA
Middle Name:RENEE
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 N WESTERN AVE # 1605
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7326
Mailing Address - Country:US
Mailing Address - Phone:877-706-6631
Mailing Address - Fax:405-289-6782
Practice Address - Street 1:2407 W WRANGLER BLVD STE B
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1917
Practice Address - Country:US
Practice Address - Phone:405-303-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV860317363LF0000X
OK206397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily