Provider Demographics
NPI:1073194619
Name:NUNN, KYLEE KRYSTINE
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:KRYSTINE
Last Name:NUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 NE FENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-1935
Mailing Address - Country:US
Mailing Address - Phone:918-876-7160
Mailing Address - Fax:
Practice Address - Street 1:401 S DEWEY AVE STE 108
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3525
Practice Address - Country:US
Practice Address - Phone:918-336-0810
Practice Address - Fax:918-336-0836
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator