WEATHERLY, MIKAELA NICOLE - 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

WEATHERLY, MIKAELA NICOLE

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:	PT SOLUTIONS AT BAILEY MEDICAL CENTER 10512 N 110TH E AVE OWASSO OK 74055 Address last updated on 8/7/2024
Phone #:	(918) 376-8550
Fax #:
County:	TULSA
License:	6369
Dated:	11/6/2023
Expires:	1/31/2025
Temp. Ltr. Issued:	6/16/2023
Temp. Ltr. Expires:	10/26/2023
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:
PT SOLUTIONS AT BAILEY MEDICAL CENTER 10512 N 110TH E AVE OWASSO OK 74055 Phone #: (918) 376-8550 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
STEVAN WAYNE JAMESON	TA	3765

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