Katheryn Noel Vandiver, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

88767 Issued in OK

Practice address

2100 SW 119TH St
Oklahoma City, OK 73170-3437

Phone

(405) 691-1041

Fax

(405) 378-3480

NPI assigned

Oct 8, 2012

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Katheryn Noel Kenemer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1235481771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SW 119TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731703437",
            "telephone_number": "405-691-1041",
            "fax_number": "405-378-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SW 119TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731703437",
            "telephone_number": "405-691-1041",
            "fax_number": "405-378-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "KATHERYN",
        "middle_name": "NOEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "88767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERYN",
            "last_name": "KENEMER",
            "middle_name": "NOEL",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry Vandergrift
• Kirsten Vanderkolk, LCSW
• Kaylee Vanderveen
• Carol Renee Vandevoir, PRSS
• Brandon Jeffery Vandiver I
• Eric Vandoorn, CRNA
• Steven J Vandrilla, BS, BHRS
• Kofi Besebro Vandyck, MD
• Jenny Vanfield
• Alison Vanheel

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.