Healthcare Provider Details

I. General information

NPI: 1922926195
Provider Name (Legal Business Name): KATELIN KINSER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE KINSER

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W 17TH ST
TULSA OK
74107-1800
US

IV. Provider business mailing address

5337 CORINTHIAN BAY DR
PLANO TX
75093-4123
US

V. Phone/Fax

Practice location:
  • Phone: 918-582-1972
  • Fax:
Mailing address:
  • Phone: 214-709-2927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: