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NPI Code Detail

MEDICARE: IESHA MARIE MCKELLOP LPN

MEDICARE: IESHA MARIE MCKELLOP LPN
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
1164W00000XLicensed Practical Nurse226383OK

General Provider Information

NPI Number : 1558227116
Entity Type Code : Individual
Provider Name (Legal Business Name) : IESHA MARIE MCKELLOP LPN
Provider Business Mailing Address
First Line : 6111 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6100
Country : US
Telephone Number : 844-458-2100
Fax Number :
Provider Business Practice Location Address
First Line : 6111 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6100
Country : US
Telephone Number : 844-458-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2025
Last Update Date : 12/29/2025

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Directions to “ IESHA MARIE MCKELLOP LPN” Practice Location

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