Provider Demographics
NPI:1497526412
Name:BATCHELOR, DYLAN NICKOLAS KENDALL
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:NICKOLAS KENDALL
Last Name:BATCHELOR
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 1:2325 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3300
Mailing Address - Country:US
Mailing Address - Phone:918-712-4301
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE # A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-712-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175F00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No175F00000XOther Service ProvidersNaturopath