MEDICARE: DANIEL KELPINE

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1962898353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL KELPINE

Provider Business Mailing Address
First Line	:	3945 SE 15TH ST
Second Line	:	SUIT 107
City	:	DEL CITY
State	:	OK
Zip	:	73115-2249
Country	:	US
Telephone Number	:	405-885-6277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3945 SE 15TH ST
Second Line	:	SUIT 107
City	:	DEL CITY
State	:	OK
Zip	:	73115-2249
Country	:	US
Telephone Number	:	405-885-6277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	04/13/2015

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