Provider Demographics
NPI:1386969467
Name:TROTTER, KATY E (APN)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:E
Last Name:TROTTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 E 71ST ST STE 7250
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6554
Mailing Address - Country:US
Mailing Address - Phone:918-492-4999
Mailing Address - Fax:918-492-4998
Practice Address - Street 1:5555 E 71ST ST STE 7250
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6554
Practice Address - Country:US
Practice Address - Phone:918-492-4999
Practice Address - Fax:918-492-4998
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0123891363LF0000X
ARA03347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR181816758Medicaid
AR181816758Medicaid