ELY, TAYLOR NICOLE - Licensee Information

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Last Update: Friday, November 22, 2024 3:47 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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

Name:	Type:	License Number:
Primary Supervisor(s):
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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