NPI Code Details Logo

NPI 1174279814

NPI 1174279814 : KELSIE ROSE YARNALL OTR/L : TULSA, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1174279814
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KELSIE ROSE YARNALL OTR/L
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/22/2022
-----------------------------------------------------
    Last Update Date     |    02/22/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8506 E 61ST ST 
-----------------------------------------------------
    City                 |    TULSA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74133-1916
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    918-202-6589
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2340 S COLLEGE AVE 
-----------------------------------------------------
    City                 |    TULSA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74114-4406
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.