Provider Demographics
NPI:1649485533
Name:GARONE, ELIZABETH KEMP (PA-C, MHS)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KEMP
Last Name:GARONE
Suffix:
Gender:F
Credentials:PA-C, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13821 TECHNOLOGY DR STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1046
Mailing Address - Country:US
Mailing Address - Phone:405-451-3454
Mailing Address - Fax:
Practice Address - Street 1:13821 TECHNOLOGY DR STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1046
Practice Address - Country:US
Practice Address - Phone:405-451-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2021-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02443363AS0400X
OK1676363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical