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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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NELSON, MARY KATHERINE       
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: UTICA PARK CLINIC
1145 S UTICA AVE STE 701
TULSA OK 74104

Address last updated on 9/24/2024
Phone #: (918) 582-6544
Fax #:
County: TULSA
License: 2957
Dated: 12/26/2018
Expires: 3/31/2025
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:
UTICA PARK CLINIC
1145 S UTICA AVE STE 701
TULSA OK 74104

Phone #: (918) 582-6544
Fax #:

Hospital Privileges:

Hillcrest Specialty Hospital
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JOHN RANDOL BERGQUIST MD 38503
EUGENE LUCAS RIZZO JR MD 39358

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