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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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MILLER, KRISTIN RENEE       
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
520 S MUSTANG RD
YUKON OK 73099

Address last updated on 3/27/2024
Phone #: (405) 936-5910
Fax #: (405) 577-2605
County: CANADIAN
License: 31454
Dated: 5/14/2015
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: General Practice
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ of Med and Hlth Sci, Basseterre, St. Kitts
Graduated: 12 / 2011
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
MERCY
520 S MUSTANG RD
YUKON OK 73099

Phone #: (405) 936-5910
Fax #: (405) 577-2605
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
736 S MUSTANG RD
YUKON, OK 73099

Phone #: (405) 437-4431
Fax #: (1) 202-
Mon:
Tue:
Wed:
Thu:
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Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KATRINA BATES APRN 112974
KIMBERLY FRANKS PA 4408
RANDY PAUL GORDON PA 1585
PAWANA ITANI APRN 20127
RHONDA MOULD APRN 70382
MANDIE WORKS APRN 79285

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