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Individual

MRS. KIMBERELY DAWN KMITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, ARNP

Contact information

Practice address
1120 S UTICA AVE, STE. G100, TULSA, OK 74104-4012
(918) 392-0175
(918) 392-0176
Mailing address
8803 S 101ST EAST AVE, STE 205, TULSA, OK 74133-5730
(918) 858-0008
(918) 858-0074

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
66134
OK
367A00000X
Advanced Practice Midwife
Primary
R0066134
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1679598809
NPI #
OK
05
200064280A
OK
Enumeration date
07/12/2006
Last updated
03/02/2017
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