HAZEL, TIFFANY NICOLE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

HAZEL, TIFFANY NICOLE

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	MERCY CLINIC ORTHOPEDIC ASSOCIATION 3301 NW 50TH ST OKLAHOMA CITY OK 73112 Address last updated on 8/28/2024
Phone #:	(405) 947-0911
Fax #:
County:	OKLAHOMA
License:	1326
Dated:	9/1/2023
Expires:	8/31/2025
Temp. Ltr. Issued:	7/26/2023
Temp. Ltr. Expires:	9/14/2023
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	0

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
MERCY CLINIC ORTHOPEDIC ASSOCIATION 3301 NW 50TH ST OKLAHOMA CITY OK 73112 Phone #: (405) 947-0911 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
MICHAEL EDWIN KIEHN	MD	23364

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