Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 33858 | OK |
NPI | 1003307935 |
---|---|
Provider Name | Mary Katlin Nixon |
First Address | Oklahoma City, OK 73104-5018 |
Second Address | Oklahoma City, OK 73104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2018 |
Last Update Date | 18/06/2018 |