KELLIE RENEE SWIM (NPI# 1518378371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518378371 |
| Entity Type | Individual |
| Full Name | KELLIE RENEE SWIM |
| Credential | APRN |
| Practice Address |
1500 E Downing St Ste 102 Tahlequah OK 74464 |
| Mailing Address |
Po Box 751 Hulbert OK 74441-0751 |
| Practice Telephone | 9182070773 |
| Practice Fax Number | 9182070774 |
| Mailing Telephone | 9187723390 |
| Mailing Fax Number | 9184310203 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2019-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
74972 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3505 W Broadway St, Muskogee, OK 744012138 | 9186838442 |
| Street Address |
1500 E DOWNING ST STE 102 |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285824045 | Kimberly Ann Milford | Pediatrics | 1500 E Downing St Ste 102, Tahlequah, OK 74464-3354 | 2007-07-27 |
| 1891097077 | Northeastern Oklahoma Community Health Centers, Inc | Clinic/Center | 1500 E Downing St Ste 102, Tahlequah, OK 74464-3354 | 2010-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033763776 | Tina Marie Fort | Nurse Practitioner | 20246 Stick Ross Mountain Rd, Tahlequah, OK 74464-7374 | 2019-07-31 |
| 1093199721 | Florame Jamison | Nurse Practitioner | 1373 E Boone St Ste 1201, Tahlequah, OK 74464-3365 | 2015-07-13 |
| 1104175736 | Christy Dawn Boswell | Nurse Practitioner | 100 S. Bliss Avenue, Tahlequah, OK 74464 | 2012-08-29 |
| 1811128028 | Ashley A Couch | Nurse Practitioner | 1500 E Downing St Ste 214, Tahlequah, OK 74464-3379 | 2009-08-05 |
| 1043409865 | Libby Leininger Rogers | Nurse Practitioner | 529 N. Oak St, Tahlequah, OK 74464-2925 | 2007-10-17 |
| 1972144475 | Shelly Diane Prince | Nurse Practitioner | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2019-10-05 |
| 1467919191 | Charity Catrina Gritts | Nurse Practitioner | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2019-02-28 |
| 1205325487 | Kristen Taylor Vazquez | Nurse Practitioner | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2018-05-03 |
| 1114424942 | Angela M Wiggins | Nurse Practitioner | 1500 E Downing St Ste 214, Tahlequah, OK 74464 | 2018-04-09 |
| 1336658053 | Dana Michelle Caviness | Nurse Practitioner | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2017-09-26 |
| Find all providers in TAHLEQUAH | ||||
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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.