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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, April 19, 2024 6:57 PM CDT
Next Update: Saturday, April 20, 2024 2:50 AM CDT

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LEWIS-WYATT, NIKI SUE
Practice Address: RELIANT DPC-CHEROKEE
221 SOUTH GRAND
CHEROKEE OK 73728

Address last updated on 3/12/2024
Phone #: (580) 307-6263
Fax #: (580) 603-8602
County: ALFALFA
License: 758
Dated: 4/1/1996
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:
RELIANT DPC-CHEROKEE
221 SOUTH GRAND
CHEROKEE OK 73728

Phone #: (580) 307-6263
Fax #: (580) 603-8602

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JONATHAN BUSHMAN DO 5032

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