Petree, Kelly Janell

Petree, Kelly Janell is an individual health care provider with primary practice located at 9228 S Mingo Rd Ste 101&103 , Tulsa OK 74133-5718. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Petree, Kelly Janell can be contacted via phone (405) 378-2727.

Contact Information

Primary practice address
9228 S Mingo Rd Ste 101&103 Tulsa OK 74133-5718
Phone: (405) 378-2727
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2020000885 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 212074 Oklahoma

Profile Details

NPI number 1982244695
LBN Legal business name Petree, Kelly Janell
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2020
Last updated Apr 19th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982244695 NPPES
Missouri MEDICAID 420080198

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