Provider Demographics
NPI:1467027367
Name:OKERSON, MARY KALEIGH (AGCNS-BC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:KALEIGH
Last Name:OKERSON
Suffix:
Gender:F
Credentials:AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 INDIANAPOLIS RD STE E
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-1591
Mailing Address - Country:US
Mailing Address - Phone:765-306-6686
Mailing Address - Fax:
Practice Address - Street 1:833 INDIANAPOLIS RD STE E
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-1591
Practice Address - Country:US
Practice Address - Phone:765-306-6686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011039A364SG0600X
IN28191376A364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health