Provider Demographics
NPI:1649769290
Name:NAIL, KADI ALLEN (NP)
Entity Type:Individual
Prefix:
First Name:KADI
Middle Name:ALLEN
Last Name:NAIL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KADI
Other - Middle Name:ALLEN
Other - Last Name:TRIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14024 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1006
Mailing Address - Country:US
Mailing Address - Phone:405-419-8465
Mailing Address - Fax:405-419-7745
Practice Address - Street 1:4400 GRANT BLVD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0037
Practice Address - Country:US
Practice Address - Phone:405-470-7414
Practice Address - Fax:405-470-5579
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11263363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0Other.