GREEN, COREY NICOLE - Licensee Information

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Last Update: Tuesday, April 23, 2024 2:12 PM CDT
Next Update: Tuesday, April 23, 2024 4:30 PM CDT

GREEN, COREY NICOLE

Practice Address:	MABEL BASSETT CORRECTIONAL CENTER 29501 KICKAPOO RD MCLOUD OK 74851 Address last updated on 3/5/2024
Phone #:	(405) 964-1656
Fax #:
County:	POTTAWATOMIE
License:	2455
Dated:	1/15/2015
Expires:	3/31/2025
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:
MABEL BASSETT CORRECTIONAL CENTER 29501 KICKAPOO RD MCLOUD OK 74851 Phone #: (405) 964-1656 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
AKHTAR HAMEED	MD	12256

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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