Healthcare Provider Details

I. General information

NPI: 1457939290
Provider Name (Legal Business Name): ASHLEY KINDER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 MCAULEY BLVD STE 303
OKLAHOMA CITY OK
73134-8704
US

IV. Provider business mailing address

13901 MCAULEY BLVD STE 303
OKLAHOMA CITY OK
73134-8704
US

V. Phone/Fax

Practice location:
  • Phone: 405-748-3129
  • Fax:
Mailing address:
  • Phone: 405-748-5800
  • Fax: 405-748-5806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberW1179
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number7647
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberBP10090428
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: