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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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KENNEDY, HEATHER CECILIA       
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: REFINE MEDICAL
2216 NW 164TH
A
EDMOND OK 73013

Address last updated on 2/5/2024
Phone #: (405) 938-0874
Fax #:
County: OKLAHOMA
License: 2191
Dated: 1/14/2013
Expires: 3/31/2025
Temp. Ltr. Issued: 12/7/2012
Temp. Ltr. Expires: 4/1/2013
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:
REFINE MEDICAL
2216 NW 164TH
A
EDMOND OK 73013

Phone #: (405) 938-0874
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
NATASHA KNOWLTON DO 4422
SANG LEE DO 3864
William B. Parsons DO 2390
TIMOTHY ALAN VAVRICKA MD 24483

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