Provider Demographics
NPI:1538139183
Name:TAYLOR, KARYN (ARNP)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:S
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 248804
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8804
Mailing Address - Country:US
Mailing Address - Phone:405-789-2111
Mailing Address - Fax:405-789-2113
Practice Address - Street 1:13316 S WESTERN AVE
Practice Address - Street 2:SUITE M
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73170-7302
Practice Address - Country:US
Practice Address - Phone:405-495-5154
Practice Address - Fax:405-601-4888
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0071175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200069680AMedicaid
OK200069680AMedicaid
OK247536102Medicare Oscar/Certification