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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, May 5, 2024 6:58 PM CDT
Next Update: Monday, May 6, 2024 2:50 AM CDT

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MILLER, CANDIECE NICOLE
Practice Address: SSM
608 NW 9TH ST #5100
OKLAHOMA CITY OK 73102

Address last updated on 3/24/2024
Phone #: (405) 772-8687
Fax #:
County: OKLAHOMA
License: 1167
Dated: 4/1/2002
Expires: 3/31/2025
Temp. Ltr. Issued: 12/13/2001
Temp. Ltr. Expires: 3/31/2002
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
SSM
608 NW 9TH ST #5100
OKLAHOMA CITY OK 73102

Phone #: (405) 772-8687
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ADAM D. GARDNER MD 30575
SYED JEHANZEB ALI NAQVI MD 28003
Peter Studebaker DO 6827

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