CARISSA DECLERCK (NPI# 1760922678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760922678 |
| Entity Type | Individual |
| Full Name | CARISSA DECLERCK |
| Credential | MSN, APRN, CPNP-PC |
| Practice Address |
1200 Childrens Ave Ste 2f Oklahoma City OK 73104-4637 |
| Mailing Address |
Po Box 269025 Oklahoma City OK 73126-9025 |
| Practice Telephone | 4052714411 |
| Mailing Telephone | 4052711500 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
94568 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200700860B | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13913 N May Ave, Oklahoma City, OK 731345035 | 4057577818 | 4057030645 |
| Street Address |
1200 CHILDRENS AVE STE 2F |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73104-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356979645 | Kayla Campbell | Dietitian, Registered | Stephenson Cancer Center, 800 Ne 10th Street, Oklahoma City, OK 73104 | 2020-03-31 |
| 1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
| 1265902340 | Jenna Lyn Celii | Registered Nurse | 920 Sl Young Blvd Ste 1140, Oklahoma City, OK 73104 | 2018-11-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1316433295 | Syed Muhammad Shakaib Quadri | Pathology | 940 Stanton L. Young Blvd., Bmsb 451, Oklahoma City, OK 73104 | 2018-07-03 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1417440793 | Helen Judith Turkson Apetor | Nurse Practitioner | 700 Ne 13th, Oklahoma City, OK 73104 | 2018-06-11 |
| 1003307935 | Mary Katlin Nixon | Obstetrics & Gynecology | 800 Stanton L Young Blvd Ste 2319, Oklahoma City, OK 73104 | 2018-05-26 |
| 1558851220 | Bryce Yohannan | Student in an Organized Health Care Education/Training Program | 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 | 2018-05-17 |
| 1346746690 | Kacy Anne Richburg | Orthopaedic Surgery | 711 Stanton L Young Blvd Ste 111, Oklahoma City, OK 73104 | 2018-04-04 |
| Find all providers in zip 73104 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383378 | Lindsey Lauren Givens | Nurse Practitioner | 17513 Aragon Ln, Oklahoma City, OK 73170-9209 | 2019-12-20 |
| 1639631781 | April Keith | Nurse Practitioner | 11204 Katie Beth Cir, Oklahoma City, OK 73170-8403 | 2019-04-05 |
| 1184917973 | Leslie Jenny Whisenhunt | Nurse Practitioner | 10400 S Western Ave, Suite 7, Oklahoma City, OK 73139-3016 | 2011-05-26 |
| 1811227911 | Okwapeds | Nurse Practitioner | 1211 N Shartel Ave Ste 606, Oklahoma City, OK 73103-2425 | 2010-01-12 |
| 1487738514 | Cynthia Louise Miller | Nurse Practitioner | Southwest Pediatrics, Pllc, 937 S.w. 89, Suite A, Oklahoma City, OK 73139 | 2006-10-25 |
| 1205462140 | Stephanie Nicole Scofield | Nurse Practitioner | 1200 Childrens Ave, Oklahoma City, OK 73104-4637 | 2020-03-22 |
| 1093352411 | Kelly Flynn | Nurse Practitioner | 1200 Childrens Ave, Oklahoma City, OK 73104-4637 | 2019-12-04 |
| 1134773567 | Rachel Gaines Sprague | Nurse Practitioner | 3330 Nw 56th St Ste 500, Oklahoma City, OK 73112-4470 | 2019-07-24 |
| 1952805368 | Kayla Freeman | Nurse Practitioner | 1200 Childrens Ave, Oklahoma City, OK 73104 | 2018-03-20 |
| 1265933725 | Jennifer Jayne Cooper | Nurse Practitioner | 1200 Childrens Ave, Oklahoma City, OK 73104-4637 | 2018-02-21 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73104 |
Please comment or provide details below to improve the information on CARISSA DECLERCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.