Provider Demographics
NPI:1770801961
Name:LAMAR, KATIE LYNN (RN, APRN)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LYNN
Last Name:LAMAR
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:LYNN
Other - Last Name:RIDDLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-945-4587
Mailing Address - Fax:405-713-4613
Practice Address - Street 1:3300 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-951-8586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0066811364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care