Provider Demographics
NPI:1649386939
Name:PATTON, KIM MARIE (ARN-P)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:MARIE
Last Name:PATTON
Suffix:
Gender:F
Credentials:ARN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SILVER HILL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3316
Mailing Address - Country:US
Mailing Address - Phone:405-557-1200
Mailing Address - Fax:405-557-1977
Practice Address - Street 1:4334 NW EXPRESSWAY STE 175
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1574
Practice Address - Country:US
Practice Address - Phone:405-557-1200
Practice Address - Fax:405-557-1977
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0034932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200261190AMedicaid
OK200261190AMedicaid