Provider Demographics
NPI:1235953183
Name:KORDELISKI, CATHERINE D (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:KORDELISKI
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 SMALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4107
Mailing Address - Country:US
Mailing Address - Phone:405-209-8234
Mailing Address - Fax:
Practice Address - Street 1:728 SMALLEY DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4107
Practice Address - Country:US
Practice Address - Phone:405-209-8234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK214950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily