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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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RUSSELL, KIMBERLY ANNE       
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: VAMC
921 NE 13TH
OKLAHOMA CITY OK 73104

Address last updated on 3/10/2024
Phone #: (405) 456-4367
Fax #:
County: OKLAHOMA
License: 744
Dated: 4/1/1996
Expires: 3/31/2025
Temp. Ltr. Issued: 8/3/1995
Temp. Ltr. Expires: 8/3/1996
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:
VAMC
921 NE 13TH
OKLAHOMA CITY OK 73104

Phone #: (405) 456-4367
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
FATIMA DE NATIVIDADE ABRANTES-PAIS MD 20092
MEHEROZ HOSHANG RABADI MD 28259

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