KELLY NESDAHL (NPI# 1336760081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336760081 |
| Entity Type | Individual |
| Full Name | KELLY NESDAHL |
| Credential | APRN |
| Practice Address |
1503 S Mission St Ste A Anadarko OK 73005-5815 |
| Mailing Address |
1216 Sw 158th St Oklahoma City OK 73170-3516 |
| Practice Telephone | 4052471100 |
| Mailing Telephone | 4055410665 |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
112029 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1503 S MISSION ST STE A |
| City | ANADARKO |
| State | OK |
| Zip Code | 73005-5815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548810534 | Wichita and Affiliated Tribes | In Home Supportive Care | 1 1/4 Mi. N Hwy 281, Anadarko, OK 73005 | 2019-09-12 |
| 1750891149 | Anadarko Nursing & Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 300 West Washington, Anadarko, OK 73005 | 2017-10-11 |
| 1457725582 | Phuong Vu | Pharmacist | 201 East Parker Mckenzie Drive, Anadarko, OK 73005 | 2015-12-01 |
| 1659745412 | Joel Wolfe | Licensed Practical Nurse | 201 East Parker Mckenzine Drive, Anadarko, OK 73005 | 2015-11-17 |
| 1891940045 | Gordon Ray Whitewolf | Counselor | 101 Riverside Drive, Riverside Indian School, Anadarko, OK 73005 | 2008-12-01 |
| 1255362646 | Gregory Dale Clift | Optometrist | 115 N. E. Oldtown Dr, Anadarko, OK 73005 | 2006-07-05 |
| 1538190921 | Marc Anthony Clanton | Psychologist | N.e. 115 Old Town Road, Anadarko, OK 73005 | 2006-07-05 |
| 1083071575 | Mildred Gomez | Registered Nurse | 201 East Parker Mckenzine Drive, Anadarko, OK 73005 | 2016-01-28 |
| 1124484324 | Rose H. Autaubo | Licensed Practical Nurse | 201 East Parker Mckenzie Drive, Anadarko, OK 73005 | 2016-01-05 |
| 1558726190 | Juliana Lonewolf | Registered Nurse | 201 East Parker Mckenzie Drive, Anadarko, OK 73005 | 2015-12-28 |
| Find all providers in zip 73005 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750828356 | Tonya Kay Jones | Nurse Practitioner | 1503 S Mission St # A, Anadarko, OK 73005-5815 | 2017-01-21 |
| 1568963403 | Randee Green | Nurse Practitioner | 1503 S Mission St, Anadarko, OK 73005-5815 | 2018-02-26 |
| 1972939122 | Jennifer Renhae Dorsey | Nurse Practitioner | 1104 E Central Blvd, Anadarko, OK 73005-4406 | 2013-09-19 |
| 1134554033 | Beverly Anne Winn | Nurse Practitioner | 1104 E Central Blvd, Anadarko, OK 73005-4406 | 2013-09-10 |
| 1659643575 | Amy Lynne Glasgow | Nurse Practitioner | 201 E Parker Mckenzie Dr, Anadarko, OK 73005 | 2012-02-08 |
| 1427142124 | Frank Molina | Nurse Practitioner | 115 N.e. Oldtown Drive, Anadarko, OK 73005-0828 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306708 | Paula Sue Brown | Nurse Practitioner | 1020 N Lawson Blvd, Clayton, OK 74536-0219 | 2020-11-06 |
| 1235730581 | Cynthia Nanett Smith | Nurse Practitioner | 3009 24th Ave Se, Norman, OK 73071-1731 | 2020-11-03 |
| 1942801246 | Preston Craig | Nurse Practitioner | 1114 Mockingbird Ln, Norman, OK 73071-4838 | 2020-11-03 |
| 1528668530 | William Zachary Mccormick | Nurse Practitioner | 9900 Ashley Pl, The Village, OK 73120-3608 | 2020-10-28 |
| 1457951519 | Crystal Marie Mapes | Nurse Practitioner | 1920 E 2nd St Apt 4015, Edmond, OK 73034-6385 | 2020-10-28 |
| 1164021655 | Alana Christine Mckinney | Nurse Practitioner | 19400 Sw 44th St, El Reno, OK 73036-8191 | 2020-10-26 |
| 1063011831 | Venvisor Health Oklahoma LLC | Nurse Practitioner | 1831 E 71st St # 4213, Tulsa, OK 74136-3922 | 2020-10-22 |
| 1164021150 | Timber Laine Jackson | Nurse Practitioner | 1391 County Road 1215, Tuttle, OK 73089-3047 | 2020-10-20 |
| 1225637465 | Dakota Bell Morton | Nurse Practitioner | 208 W 35th St, Sand Springs, OK 74063-2832 | 2020-10-19 |
| 1942808746 | Shari E Stapleton | Nurse Practitioner | 324 Ceder Ln, Tuttle, OK 73089-8675 | 2020-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.