Healthcare Provider Details

I. General information

NPI: 1154245496
Provider Name (Legal Business Name): KM HEALTHCARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9076 S 253RD EAST AVE
BROKEN ARROW OK
74014-5591
US

IV. Provider business mailing address

PO BOX 140353
BROKEN ARROW OK
74014-0017
US

V. Phone/Fax

Practice location:
  • Phone: 918-708-2777
  • Fax: 918-358-6659
Mailing address:
  • Phone: 918-708-2777
  • Fax: 918-358-6659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KASIE MENDENHALL
Title or Position: OWNER, CEO
Credential:
Phone: 918-708-2777