KALEB REDICK (NPI# 1396382883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396382883 |
| Entity Type | Individual |
| Full Name | KALEB REDICK |
| Credential | RN, BSN FNP |
| Practice Address |
1620 E 12th St Tulsa OK 74120-5407 |
| Mailing Address |
1201 Covell Village Dr Apt 330 Edmond OK 73003-9720 |
| Practice Telephone | 9185822131 |
| Mailing Telephone | 4056130502 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
113244 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1620 E 12TH ST |
| City | TULSA |
| State | OK |
| Zip Code | 74120-5407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982161568 | James D Pollard | Social Worker | 1620 E 12th St, Tulsa, OK 74120-5407 | 2019-03-01 |
| 1942700497 | Diana Lynn Tatro | Case Manager/Care Coordinator | 1620 E 12th St, Tulsa, OK 74120-5407 | 2018-02-20 |
| 1942616289 | Michele Despain | Registered Nurse | 1620 E 12th St, Tulsa, OK 74120-5407 | 2014-07-08 |
| 1447663158 | Frances Whisman | Registered Nurse | 1620 E 12th St, Tulsa, OK 74120-5407 | 2014-06-10 |
| 1316282684 | Uchenna Okolonwamu | Physician Assistant | 1620 E 12th St, Tulsa, OK 74120-5407 | 2012-11-27 |
| 1316295470 | Tina Cooper | Counselor | 1620 E 12th St, Tulsa, OK 74120-5407 | 2012-08-21 |
| 1639448079 | William James List | Social Worker | 1620 E 12th St, Tulsa, OK 74120-5407 | 2011-12-14 |
| 1518235019 | Rosemarie Capps | Social Worker | 1620 E 12th St, Tulsa, OK 74120-5407 | 2011-12-12 |
| 1538437140 | Noel Patrick Harter | Counselor | 1620 E 12th St, Tulsa, OK 74120-5407 | 2011-12-09 |
| 1710299128 | Seana Lynn Petri | Counselor | 1620 E 12th St, Tulsa, OK 74120-5407 | 2010-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144704321 | Quintella Delana Miller | Case Manager/Care Coordinator | 1043 E Easton St, Tulsa, OK 74120 | 2018-09-24 |
| 1689152092 | Charles Granger Jr. | Case Manager/Care Coordinator | 103 N Greenwood, Suite 320, Tulsa, OK 74120 | 2018-07-30 |
| 1174015598 | Debra Anne Beasley | Counselor | 1619 E. 13th St., Tulsa, OK 74120 | 2018-06-01 |
| 1649775701 | Cara Marie Cantu | Licensed Practical Nurse | 620 South Peoria, Tulsa, OK 74120 | 2018-03-29 |
| 1639558745 | Wei Te Li | Student in an Organized Health Care Education/Training Program | 1207 S Quaker Ave Apt 104, Tulsa, OK 74120 | 2015-05-21 |
| 1225434350 | Marcos Rivero | Community/Behavioral Health | 130 N. Greenwood, Suite 302, Tulsa, OK 74120 | 2014-11-18 |
| 1861742348 | Tamiika Jones | Social Worker | 1533 E 13th St, Apt B, Tulsa, OK 74120 | 2012-09-12 |
| 1730408097 | Teresa Lee Henshaw | Physical Therapist | 1125 S. Trenton, Hillcrest Medical Center- Kaiser Rehab. Center, Tulsa, OK 74120 | 2010-05-26 |
| 1194970384 | Kym Lynnette Lindsay | Speech-Language Pathologist | 1125 S Trenton Ave Fl 3, Tulsa, OK 74120 | 2008-12-01 |
| 1184872004 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Pediatrics | 619 S. Quincy Ave., Ouptch-laura Dester Shelter, Tulsa, OK 74120 | 2008-09-04 |
| Find all providers in zip 74120 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011831 | Venvisor Health Oklahoma LLC | Nurse Practitioner | 1831 E 71st St # 4213, Tulsa, OK 74136-3922 | 2020-10-22 |
| 1235742941 | Emily Christine Cobbs | Nurse Practitioner | 5740 E 29th St, Tulsa, OK 74114-6408 | 2020-08-24 |
| 1184234742 | Jenni Rigney | Nurse Practitioner | 1713 S Peoria Ave Ste A, Tulsa, OK 74120-6801 | 2020-08-07 |
| 1477163087 | Amy Marie Thomas | Nurse Practitioner | 9001 S 101st East Ave Ste 200, Tulsa, OK 74133-5711 | 2020-08-07 |
| 1225653512 | Channel Johnson | Nurse Practitioner | 766 N Zenith Ave, Tulsa, OK 74127-5232 | 2020-06-11 |
| 1326663857 | Bethany Lemley | Nurse Practitioner | 1217 S Atlanta Pl, Tulsa, OK 74104-4310 | 2020-06-10 |
| 1952939340 | Kairie Swift | Nurse Practitioner | 3321 S Yale Ave, Tulsa, OK 74135-8011 | 2020-03-31 |
| 1023642899 | Shannon Lee Davis | Nurse Practitioner | 1400 S Boston Ave, Tulsa, OK 74119-3612 | 2020-03-02 |
| 1871126573 | Chelsea Allen | Nurse Practitioner | 9175 S Yale Ave Ste 220, Tulsa, OK 74137-4043 | 2020-02-20 |
| 1982255352 | Crystal L Gazda | Nurse Practitioner | 4103 S Yale Ave Ste C, Tulsa, OK 74135-6002 | 2019-09-26 |
| Find all providers in TULSA | ||||
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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.