Provider Demographics
NPI:1609267434
Name:ADAMS, KARI LANE
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LANE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4505 MEMORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-5004
Mailing Address - Country:US
Mailing Address - Phone:405-749-7099
Mailing Address - Fax:405-755-9237
Practice Address - Street 1:4505 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-5004
Practice Address - Country:US
Practice Address - Phone:405-749-7099
Practice Address - Fax:405-755-9237
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK104369363LF0000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics