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Oklahoma Board of Medical Licensure and Supervision

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

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HERNANDEZ, GINA ELIZABETH       
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: GOOD SHEPHERD COMMUNITY CLINIC
1104 WALNUT DR
ARDMORE OK 73401

Address last updated on 3/1/2024
Phone #: (580) 226-0543
Fax #: (580) 226-2284
County: CARTER
License: 1401
Dated: 4/1/2005
Expires: 3/31/2025
Temp. Ltr. Issued: 12/9/2004
Temp. Ltr. Expires: 4/2/2005
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
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:
GOOD SHEPHERD COMMUNITY CLINIC
1104 WALNUT DR
ARDMORE OK 73401

Phone #: (580) 226-0543
Fax #: (580) 226-2284

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
MICHAEL WAYNE CARNAHAN MD 16887

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