Provider Demographics
NPI:1316912736
Name:SIGLER, MARY KATHRYN (ARNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:SIGLER
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHRYN
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-6830
Mailing Address - Country:US
Mailing Address - Phone:918-540-7475
Mailing Address - Fax:918-540-7473
Practice Address - Street 1:200 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6830
Practice Address - Country:US
Practice Address - Phone:918-540-7475
Practice Address - Fax:918-540-7473
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37879363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200016880AMedicaid
S74729Medicare UPIN
OK241331506Medicare PIN
OK246725005Medicare PIN
OK243711101Medicare PIN
OKDA1415Medicare PIN
OKP00457019Medicare PIN