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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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LANE, SHELLEY KAY       
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: 12191 S 105TH E AVE
BIXBY OK 74008

Address last updated on 12/29/2023
Phone #: (918) 633-1411
Fax #:
County: TULSA
License: 1484
Dated: 10/14/1988
Expires: 1/31/2025
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
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:
12191 S 105TH E AVE
BIXBY OK 74008

Phone #: (918) 633-1411
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JOSHUA ANTHONY BUTTON TA 2126
JOHANNA ALENE CUMMINGS TA 1077
KIMBERLY SUZANNE DAVIS TA 1975
LAURA BERNICE DAVIS TA 251
JACOB DANIEL DUPREE TA 2840
AMANDA LEA FAUGHT TA 1082
AMBER FIELDS TA 2477
RYAN MILLER GIBSON TA 2712
KELSIE RENEE GOETZ TA 2130
HUMBERTO GRIMALDO-SALAZAR TA 1948
DEBORAH DIANE HILDEBRAND TA 818
TENLEY ELIZABETH HILL TA 1099
JESSICA EMILYE JACKSON TA 2475
ALEXIS DAWN JACKSON TA 2766
ALICIA DAWN JOBE TA 3398
VICTORIA JUNE JONES TA 1630
LAUREN NOELLE JONES TA 2708
AMANDA BROOKE KENNEDY TA 1749
DOROTHEA INGE KERNS TA 1628
LA TOYA MECHELLE MEYER TA 1836
KEISHA JUANELL NELSON TA 1750
MELISSA DAWN PARKER TA 3193
HAYDEN M'LISS PERRY TA 3333
MORGAN DEANN PHILLIPS TA 2857
GLENNA ARLENE PIPINS TA 76
KAITLYN BETH RICHARDSON TA 3744
CHASSITY AUTUMN RUBERT TA 921
LEAH MARIE RYAN TA 1477
EMILY LAUREN SCHULTHEIS TA 1612
CONNIE SUE SMITH TA 596
BRECKEN LEE WAITMAN TA 3148
ALLI MARIE WILLIS TA 3862
DAMION WOLFE TA 2523

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