Ketner, Elena Marie

Ketner, Elena Marie is an individual health care provider with primary practice located at 3401 W Gore Blvd , Lawton OK 73505-6332. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ketner, Elena Marie can be contacted via phone (580) 355-8620.

Contact Information

Primary practice address
3401 W Gore Blvd Lawton OK 73505-6332
Phone: (580) 355-8620
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 207300 Oklahoma

Profile Details

NPI number 1497179543
LBN Legal business name Ketner, Elena Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2014
Last updated Apr 19th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497179543 NPPES
Oklahoma MEDICAID 1497179543

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