Healthcare Provider Details
I. General information
NPI: 1063945467
Provider Name (Legal Business Name): KAITLYN ELIZABETH O'KEEFE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2017
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2711 RANDOLPH RD STE 400
CHARLOTTE NC
28207-2027
US
IV. Provider business mailing address
PO BOX 3710
HICKORY NC
28603-3710
US
V. Phone/Fax
- Phone: 704-342-1900
- Fax:
- Phone: 828-324-9550
- Fax: 828-324-9145
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 2020-02969 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 91271 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 91271 |
| License Number State | SC |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 2020-02969 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: