Healthcare Provider Details
I. General information
NPI: 1356263404
Provider Name (Legal Business Name): KAYLEE D TERRELL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3125 NW 184TH TER
EDMOND OK
73012-7681
US
IV. Provider business mailing address
3125 NW 184TH TER
EDMOND OK
73012-7681
US
V. Phone/Fax
- Phone: 405-448-0092
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAYLEE
TERRELL
Title or Position: OWNER
Credential:
Phone: 405-448-0092