Provider Demographics
NPI:1306584438
Name:SPITZ, KELSEY ANNE (APRN)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:ANNE
Last Name:SPITZ
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-949-3417
Mailing Address - Fax:405-552-5165
Practice Address - Street 1:3300 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-949-3417
Practice Address - Fax:405-552-5165
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OKR0126281163W00000X
OK209303364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse