PUCKETT, KENNEDI ELIZABETH WHITLEY - 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

PUCKETT, KENNEDI ELIZABETH WHITLEY

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:	SSM HEALTH MEDICAL GROUP FAMILY MEDICINE CENTER 1110 N LEE AVE SUITE 300 OKLAHOMA CITY OK 73103 Address last updated on 8/12/2024
Phone #:	(405) 231-3000
Fax #:
County:	OKLAHOMA
License:	5027
Dated:	5/8/2023
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:
SSM HEALTH MEDICAL GROUP FAMILY MEDICINE CENTER 1110 N LEE AVE SUITE 300 OKLAHOMA CITY OK 73103 Phone #: (405) 231-3000 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
KEENAN L FERGUSON	DO	4405
ADAM MCCONNELL	MD	38648

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