Provider Demographics
NPI:1639149008
Name:REDYKE, KATHRYN ELAINE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELAINE
Last Name:REDYKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELAINE
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1171 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2505
Mailing Address - Country:US
Mailing Address - Phone:515-235-0462
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:1007 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4495
Practice Address - Country:US
Practice Address - Phone:918-587-1101
Practice Address - Fax:918-587-0589
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0067680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily