Provider Demographics
NPI:1679249080
Name:BUERKER, KATLYN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:BUERKER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E BLUE STARR DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-4223
Mailing Address - Country:US
Mailing Address - Phone:918-341-8100
Mailing Address - Fax:918-341-8139
Practice Address - Street 1:32208 E 142ND ST S
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-5744
Practice Address - Country:US
Practice Address - Phone:580-271-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK205139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily