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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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GRAYSON, NANCY ELLEN       
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: 25353 E 840 RD
KINGFISHER OK 73750

Address last updated on 1/5/2024
Phone #: (918) 808-3306
Fax #: (888) 504-7682
County: OKLAHOMA
License: 17590
Dated: 2/28/1991
Expires: 2/1/2025
License Type: Medical Doctor
Specialty: Psychiatry
Addiction Psychiatry
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1985
CME Year: 2025
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
11/4/2010 Probation Ended
3/13/2008 Probation
9/20/2007 Suspension, License
8/13/2007 Complaint Citation
Board Filings and/or Orders:
11/04/2010
03/13/2008
09/20/2007
09/20/2007
08/10/2007
08/10/2007
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
New Patients: No
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
Hospital Privileges: None listed
Locations: Hours: Languages:
25353 E 840 RD
KINGFISHER OK 73750

Phone #: (918) 808-3306
Fax #: (888) 504-7682
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
CANDICE RAE BREEDEN PA 1512
ROBIN POTTER-KIMBALL APRN 46325

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