Kaley Pieratt
Individual provider Active NPI Registered Nurse · Bristow, OK
NPI 1790172088 · NPPES record last updated Apr 24, 2015
Key facts
- NPI
- 1790172088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 104870 (OK)
- Practice address
- 19225 S 289TH West Ave
Bristow, OK 74010-2238 - Phone
- (918) 697-2813
- NPI assigned
- Apr 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 104870 | OK | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 104870 | OK | Yes |
Addresses
Primary practice location
19225 S 289TH West Ave
Bristow, OK 74010-2238
Mailing address
19225 S 289TH West Ave
Bristow, OK 74010-2238
Other providers in Bristow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2015. 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.