Provider Demographics
NPI:1922845189
Name:DAVIS, KYRA NICOLE (DNP, APRN, CNP)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 HIDDEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-9684
Mailing Address - Country:US
Mailing Address - Phone:405-626-4905
Mailing Address - Fax:
Practice Address - Street 1:5525 HIDDEN MEADOW DR
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-9684
Practice Address - Country:US
Practice Address - Phone:405-626-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily