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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, April 29, 2024 7:03 PM CDT
Next Update: Tuesday, April 30, 2024 2:50 AM CDT

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KENNEDY, ALLIE NICOLE
Practice Address: ASCENSION ST. JOHN ENT HEAD AND NECK SURGERY
1919 SOUTH WHEELING AVE
TULSA OK 74104

Address last updated on 2/16/2024
Phone #: (918) 403-6284
Fax #:
County: TULSA
License: 4763
Dated: 2/8/2022
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:
ASCENSION ST. JOHN ENT HEAD AND NECK SURGERY
1919 SOUTH WHEELING AVE
TULSA OK 74104

Phone #: (918) 403-6284
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
CHANGXING LIU MD 35961
Brad Mons DO 5413

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