Healthcare Provider Details

I. General information

NPI: 1275486573
Provider Name (Legal Business Name): KAYTLYN NICOLE VESS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W TROWER BLVD
MANNFORD OK
74044-3116
US

IV. Provider business mailing address

777 NW 63RD ST FL 2
OKLAHOMA CITY OK
73116-7601
US

V. Phone/Fax

Practice location:
  • Phone: 539-357-2499
  • Fax:
Mailing address:
  • Phone: 405-445-1210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226788
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: