Provider Demographics
NPI:1972268548
Name:REGENHARD, KIMBERLY KAYE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAYE
Last Name:REGENHARD
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:KAYE
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:9228 S MINGO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5722
Mailing Address - Country:US
Mailing Address - Phone:918-592-0999
Mailing Address - Fax:918-592-1021
Practice Address - Street 1:9228 S MINGO RD STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5722
Practice Address - Country:US
Practice Address - Phone:918-592-0999
Practice Address - Fax:918-592-1021
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK205778363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care