CASTLEBERRY, CODI NICOLE - Licensee Information

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Last Update: Thursday, April 18, 2024 6:52 PM CDT
Next Update: Friday, April 19, 2024 2:50 AM CDT

CASTLEBERRY, CODI NICOLE

Practice Address:	MEDWISE URGENT CARE 32 W TAFT AVE SAPULPA OK 74066 Address last updated on 3/21/2024
Phone #:	(918) 727-2841
Fax #:
County:	CREEK
License:	2891
Dated:	2/9/2018
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:
MEDWISE URGENT CARE 32 W TAFT AVE SAPULPA OK 74066 Phone #: (918) 727-2841 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
SAMANTHA LEIGH WHITESIDE	MD	27775

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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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