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NPI Code Detail

MEDICARE: CALLIE JEANNE KINZIE

MEDICARE: CALLIE JEANNE KINZIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianOK

General Provider Information

NPI Number : 1083550016
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLIE JEANNE KINZIE
Provider Business Mailing Address
First Line : 5016 NW 61ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73122-7409
Country : US
Telephone Number : 572-568-9255
Fax Number :
Provider Business Practice Location Address
First Line : 15201A CROWN AT LONE OAK RD
Second Line :
City : EDMOND
State : OK
Zip : 73013-2272
Country : US
Telephone Number : 888-423-6456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2026
Last Update Date : 04/23/2026

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Directions to “ CALLIE JEANNE KINZIE ” Practice Location

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