Healthcare Provider Details

I. General information

NPI: 1598679243
Provider Name (Legal Business Name): KELSEY DRAPEAU PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13420 N PIEDMONT RD
YUKON OK
73099-5680
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 405-883-3480
  • Fax: 405-883-3481
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4202
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: