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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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HEINLEN, LATISHA DAWN       
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: 7336 N CLASSEN BLVD
SUITE 100
OKLAHOMA CITY OK 73116

Address last updated on 8/16/2024
Phone #: (405) 608-8060
Fax #: (405) 608-8070
County: OKLAHOMA
License: 26317
Dated: 7/16/2009
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Rheumatology
Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2008
CME Year: 2027
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.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Rheumatology
New Patients: Yes
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
7336 N CLASSEN BLVD
SUITE 100
OKLAHOMA CITY OK 73116

Phone #: (405) 608-8060
Fax #: (405) 608-8070
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4400 Grant Boulevard
Suite 103
Yukon, OK 73099

Phone #: (405) 608-8060
Fax #: (5) 202-
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501 SW 149th ST
Suite A
Oklahoma City, OK 73170

Phone #: (405) 608-8060
Fax #: (5) 202-
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMANDA OBLANDER APRN 93802
LACEY ROACH APRN 123091
AMY CHRISTINE WALKER PA 1419

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