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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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ABRAHAM, NICHOLE       
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: PERRY A. KLAASSEN FAMILY MEDICAL CENTER
1006 NE 17TH ST
OKLAHOMA CITY OK 73111

Address last updated on 10/18/2024
Phone #: (405) 419-9800
Fax #:
County: OKLAHOMA
License: 5045
Dated: 6/27/2023
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:
PERRY A. KLAASSEN FAMILY MEDICAL CENTER
1006 NE 17TH ST
OKLAHOMA CITY OK 73111

Phone #: (405) 419-9800
Fax #:

Hospital Privileges:

INTEGRIS Baptist Medical Center
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
SSM Health St. Anthony Shawnee Hospital (fmly Unity Health Ctr)
Shawnee, OK
Stillwater Medical Center
Stillwater, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
SHELEATHA MICHELLE TAYLOR-BRISTOW MD 27765

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