Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimmie Phisaiwath, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1639662216

Kimmie Phisaiwath, APRN-CNP is a Nurse Practitioner in Oklahoma City, Oklahoma. Qualified in 2018, 8 years ago. Practices with Ohh Physicians LLC, a 133-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
8
Licensed in
OK
In the registry since
2018
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4050 W Memorial Rd Fl 3
Oklahoma City, OK 73120-8382
Phone: (405) 608-3855
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R009993 (OK)

Record details

NPI number1639662216
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedJune 8, 2018
Last updated in NPPESNovember 15, 2024
Certification dateNovember 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Ohh Physicians Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Oklahoma City