Davis, Kelly Lynn
Davis, Kelly Lynn is an sole proprietor health care provider with primary practice located at 18247 W Running Springs Rd , Park Hill OK 74451-2017. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Contractor, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is her primary health care specialty. Davis, Kelly Lynn can be contacted via phone (918) 441-6337.Contact Information
Primary practice address
18247 W Running Springs Rd
Park Hill OK 74451-2017
Phone: (918) 441-6337
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1346501202 |
|---|---|
| LBN Legal business name | Davis, Kelly Lynn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2012 |
| Last updated | Jun 6th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346501202 | NPPES |
| Oklahoma | MEDICAID | 200305190B |
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