Active NPI
Kylie Mishael Self, BSN, RN
- Registered Nurse
- Durant, OK
National Provider Identifier
1831583137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R 0110761
- Practice address
- 1001 W Main St
Durant, OK 74701-5038 - Phone
- (580) 924-7330
- NPI assigned
- Mar 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R 0110761 | OK | Primary |
Addresses
Primary practice location
1001 W Main St
Durant, OK 74701-5038
Mailing address
82 Blue Stem Road
Caddo, OK 74729-3019
Phone (580) 434-2719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 0110761 | OK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505952000000",
"number": "1831583137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 BLUE STEM ROAD",
"city": "CADDO",
"state": "OK",
"postal_code": "747293019",
"telephone_number": "580-434-2719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 W MAIN ST",
"city": "DURANT",
"state": "OK",
"postal_code": "747015038",
"telephone_number": "580-924-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "KYLIE",
"middle_name": "MISHAEL",
"name_prefix": "Miss",
"credential": "BSN, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-24",
"last_updated": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "R 0110761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.