Provider Demographics
NPI:1316532377
Name:TREKELL, KIM YVETTE (APRN)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:YVETTE
Last Name:TREKELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:OK
Mailing Address - Zip Code:73741-1018
Mailing Address - Country:US
Mailing Address - Phone:405-421-6503
Mailing Address - Fax:
Practice Address - Street 1:216 N MURRAY ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:OK
Practice Address - Zip Code:73741-1018
Practice Address - Country:US
Practice Address - Phone:405-421-6503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0075314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily