Provider Demographics
NPI:1780140871
Name:BROOKS, KATHERINE MCNEILL
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCNEILL
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MCNEILL
Other - Last Name:ROWLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3333
Mailing Address - Country:US
Mailing Address - Phone:918-488-6653
Mailing Address - Fax:
Practice Address - Street 1:10507 E 91ST ST STE 450
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5515
Practice Address - Country:US
Practice Address - Phone:918-494-4460
Practice Address - Fax:918-494-4442
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3186363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant