Provider Demographics
NPI:1598098717
Name:WENTHOLD, KENNA SUE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KENNA
Middle Name:SUE
Last Name:WENTHOLD
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 1:1000 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:KINGFISHER
Mailing Address - State:OK
Mailing Address - Zip Code:73750-5002
Mailing Address - Country:US
Mailing Address - Phone:405-375-7847
Mailing Address - Fax:405-375-7849
Practice Address - Street 1:1000 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750
Practice Address - Country:US
Practice Address - Phone:405-375-7847
Practice Address - Fax:405-375-7849
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0078613363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner