Kelly Diane Teal I, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

R0075252 Issued in OK

Practice address

1101 E Monroe Ave
McAlester, OK 74501-4815

Phone

(918) 426-7800

Fax

(918) 426-5837

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1700628781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 EDWARDS LN",
            "city": "INDIANOLA",
            "state": "OK",
            "postal_code": "744425149",
            "telephone_number": "918-426-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E MONROE AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014815",
            "telephone_number": "918-426-7800",
            "fax_number": "918-426-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAL",
        "first_name": "KELLY",
        "middle_name": "DIANE",
        "name_suffix": "I",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OK",
            "license": "R0075252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Registered Nurse in McAlester, OK
• Providers in McAlester, OK by specialty
• Community Health Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.