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General NPI Number Information
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NPI Number | 1669204723
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Entity Type | Individual
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Provider Name | JADE KASS ATC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 5401 S SHIELDS BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73129-3621
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Country | US
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Telephone | 405-587-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 9516 S SHIELDS BLVD APT 154
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City | MOORE
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State | OK
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Zip | 73160-3123
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Country | US
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Telephone | 816-617-2870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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