Kevin Ray Charboneau, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

R0065871 Issued in OK

Practice address

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Phone

(918) 577-3361

NPI assigned

May 28, 2025

Sex

Male

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1780477133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONEAU",
        "first_name": "KEVIN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OK",
            "license": "R0065871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela B Catlett, MS, LPC
• Destiny Catron
• Caysie N Garza Aprn FNP-C LLC
• Chancey Natashia Chandler, RN
• Chandrasekhar Polepalle MD Inc
• Charles a. Lester MD PC
• Angela Sue Charlton, O.D.
• Karen Chase
• Debasish Chaudhuri, MD
• Allison Rebecca Chavarria

• Case Management Registered Nurse in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Case Management Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.