Healthcare Provider Details

I. General information

NPI: 1912796152
Provider Name (Legal Business Name): KELSEY GELVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 BEAUMONT DR # DRIVE221
NORMAN OK
73071-2255
US

IV. Provider business mailing address

1800 BEAUMONT DR # DRIVE221
NORMAN OK
73071-2255
US

V. Phone/Fax

Practice location:
  • Phone: 405-540-0726
  • Fax:
Mailing address:
  • Phone: 405-540-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: