WILKIN, KACIE LEANN - Licensee Information

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

WILKIN, KACIE LEANN

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:	CHICKASAW NATION DEPARTMENT OF HEALTH 1921 STONECIPHER BLVD ADA OK 74820-0000 Address last updated on 2/15/2024
Phone #:	(580) 436-3980
Fax #:
County:	PONTOTOC
License:	2501
Dated:	4/30/2015
Expires:	3/31/2025
Temp. Ltr. Issued:	2/6/2015
Temp. Ltr. Expires:	5/15/2015
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:
CHICKASAW NATION DEPARTMENT OF HEALTH 1921 STONECIPHER BLVD ADA OK 74820-0000 Phone #: (580) 436-3980 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
PHILLIP TYLER FULLER	MD	30483

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