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NPI Code Detail

MEDICARE: KAITLYN M METCALFE

MEDICARE: KAITLYN M METCALFE
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1538797287
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN M METCALFE
Provider Business Mailing Address
First Line : 5949 N REDMOND AVE
Second Line :
City : WARR ACRES
State : OK
Zip : 73122-7105
Country : US
Telephone Number : 580-512-9199
Fax Number :
Provider Business Practice Location Address
First Line : 823 N VILLA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-6439
Country : US
Telephone Number : 405-208-7207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 03/30/2020

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Directions to “ KAITLYN M METCALFE ” Practice Location

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