ROBERTSON, DESTINY DENAE - Licensee Information

Search Results

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

ROBERTSON, DESTINY DENAE

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:	NORTHWEST FAMILY MEDICINE 7301 NORTH COMANCHE OKLAHOMA CITY OK 73132 Address last updated on 3/26/2024
Phone #:	(405) 728-2100
Fax #:	(405) 728-2244
County:	OKLAHOMA
License:	4596
Dated:	5/27/2021
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:
NORTHWEST FAMILY MEDICINE 7301 NORTH COMANCHE OKLAHOMA CITY OK 73132 Phone #: (405) 728-2100 Fax #: (405) 728-2244

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
REBECCA ANN FAULKNER	MD	21688
LARRY LOVELACE	DO	2438

Return to Search Licensees page