Healthcare Provider Details
I. General information
NPI: 1447104575
Provider Name (Legal Business Name): MACEY KLEYN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/25/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14101 PARKWAY COMMONS DR
OKLAHOMA CITY OK
73134-6012
US
IV. Provider business mailing address
18913 CASERO DR
EDMOND OK
73012-4044
US
V. Phone/Fax
- Phone: 405-749-2700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | 230602 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | R0133600 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: