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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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NIX, CARLY       
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: MCBRIDE ORTHOPEDIC CLINIC
9600 BROADWAY EXTENSION
OKLAHOMA CITY OK 73114
Address last updated on 12/28/2023
Phone #: (405) 230-9575
Fax #: (405) 230-9585
County: OKLAHOMA
License: 5884
Dated: 8/5/2020
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:
MCBRIDE ORTHOPEDIC CLINIC
9600 BROADWAY EXTENSION
OKLAHOMA CITY OK 73114
Phone #: (405) 230-9575
Fax #: (405) 230-9585
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KAYLA JOLYNN ALLEN TA 2374
HOLLY ELIZABETH ELLIOTT TA 2467
MICHAEL DANIEL EVANS TA 2296
RICHARD KOHL FRANCIS TA 3528
KINSEY SUE HOWARD TA 1149
KAYLEE LYNN LONG TA 2885
ERICCA MARIE MANDELKOW TA 1676
TED CHARLES MOORE TA 500
PHU TIEN NGUYEN TA 3531
ANDREW KENNETH PEELER TA 2654
STACY MICHELLE VITATOE TA 1905
JENNIFER BROOKE WRIGHT TA 2646

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