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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 1:13 PM CST
Next Update: Sunday, December 22, 2024 4:30 PM CST

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ELY, TAYLOR NICOLE       
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: DUNCAN REGIONAL HOSPITAL
2621 WHISENANT DR
DUNCAN OK 73533

Address last updated on 3/17/2024
Phone #: (580) 252-5300
Fax #:
County: STEPHENS
License: 4660
Dated: 11/1/2021
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:
DUNCAN REGIONAL HOSPITAL
2621 WHISENANT DR
DUNCAN OK 73533

Phone #: (580) 252-5300
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
Burke R. Hendricks DO 6415
BRANDY NICOLE MONTES MD 30832
Ross O. Owens DO 5789
JAMES ROBERT PETERSEN DO 5698
Taylor Scott DO 6755

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