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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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ELKINS, NICOLE RACHELLE       
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: 2002 12TH AVE NW SUITE D
ARDMORE OK 73401

Address last updated on 10/3/2024
Phone #: (580) 226-8646
Fax #:
County: CARTER
License: 1788
Dated: 4/1/2009
Expires: 3/31/2025
Temp. Ltr. Issued: 12/19/2008
Temp. Ltr. Expires: 4/3/2009
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:
2002 12TH AVE NW SUITE D
ARDMORE OK 73401

Phone #: (580) 226-8646
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JEFFREY A BUYTEN MD 26178
SCOTT ALLEN DEMPEWOLF MD 20353
JEREMY ADAM MOORE MD 25527

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