Provider Demographics
NPI:1679582274
Name:PARKER, KATHLEEN RENE (PHD, APRN-CNP)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:RENE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD, APRN-CNP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:RENE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ARNP
Mailing Address - Street 1:921 NE 13TH ST
Mailing Address - Street 2:NUR (118)
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5007
Mailing Address - Country:US
Mailing Address - Phone:405-456-3787
Mailing Address - Fax:405-456-5961
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:NUR (118)
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-456-3787
Practice Address - Fax:405-456-5961
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0045933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP3515OtherVAMC PROVIDER ID
OKP3515OtherVAMC PROVIDER ID