Provider Demographics
NPI:1336996560
Name:PURSER, KATHERYNE LANE
Entity Type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:LANE
Last Name:PURSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 NW 39TH ST APT 206
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-2646
Mailing Address - Country:US
Mailing Address - Phone:405-800-6420
Mailing Address - Fax:
Practice Address - Street 1:1812 NW 39TH ST APT 206
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2646
Practice Address - Country:US
Practice Address - Phone:405-800-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist