Mary Kekahbah
Individual provider Active NPI Nurse Practitioner · Hominy, OK
NPI 1154945285 · NPPES record last updated Jun 4, 2020
Key facts
- NPI
- 1154945285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AG02200097 (OK)
- Practice address
- 129 Conner Rd
Hominy, OK 74035-2100 - Phone
- (918) 594-1300
- NPI assigned
- Jun 4, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AG02200097 | OK | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AG02200097 | OK | Yes |
Addresses
Primary practice location
129 Conner Rd
Hominy, OK 74035-2100
Mailing address
1121 Rogers Ave
Pawhuska, OK 74056-3046
Other providers in Hominy, OK
- Katelyn S Fitzgerald
- Heel to Toe Foot Care Plus Inc
- Hominy Community Medical Trust Authority
- Hominy Public School
- Hominy Rexall Inc
- Wendy Denise Madison
- Timothy William Mauer
- Jeffrey Todd Nance
- Katherine Elizabeth Owens
- Monica Alvina Phillips I
All providers in Hominy, OK · Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.