Healthcare Provider Details

I. General information

NPI: 1548868573
Provider Name (Legal Business Name): KAYLA LYNN BIRCHFIELD APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S GRAND ST
CRESCENT OK
73028-9118
US

IV. Provider business mailing address

400 S GRAND ST
CRESCENT OK
73028-9118
US

V. Phone/Fax

Practice location:
  • Phone: 405-969-2818
  • Fax: 405-969-2821
Mailing address:
  • Phone: 405-969-2818
  • Fax: 405-969-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201892
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: