Provider Demographics
NPI:1982198131
Name:ELLIOTT, KARI L (DNP, CPNP-PC, AE-C)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:580-762-9355
Mailing Address - Fax:580-765-0336
Practice Address - Street 1:1908 N 14TH ST STE 207
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2039
Practice Address - Country:US
Practice Address - Phone:580-762-9355
Practice Address - Fax:580-765-0336
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK213340363LP0200X, 363LF0000X
MO2018020187363LN0000X, 363LP0200X
MO2021039624363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal