Healthcare Provider Details

I. General information

NPI: 1275362402
Provider Name (Legal Business Name): MEAGAN JOYCE KITE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 N MONTE VISTA ST
ADA OK
74820-7711
US

IV. Provider business mailing address

807 N MONTE VISTA ST
ADA OK
74820-7711
US

V. Phone/Fax

Practice location:
  • Phone: 580-332-8855
  • Fax:
Mailing address:
  • Phone: 580-332-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number221405
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: