Provider Demographics
NPI:1992341531
Name:PFAFF, KARLEE JO (PA-C)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:JO
Last Name:PFAFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARLEE
Other - Middle Name:JO
Other - Last Name:TORGERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:10808 GLOVER RIVER DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 N W 164TH ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013
Practice Address - Country:US
Practice Address - Phone:405-252-8761
Practice Address - Fax:405-252-8762
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3130363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical