Provider Demographics
NPI:1619528627
Name:CLINE, KRISTIN DEE (CPED)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:DEE
Last Name:CLINE
Suffix:
Gender:F
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6565 S YALE AVE STE 909
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8310
Mailing Address - Country:US
Mailing Address - Phone:918-502-5975
Mailing Address - Fax:918-502-5980
Practice Address - Street 1:6565 S YALE AVE STE 909
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8310
Practice Address - Country:US
Practice Address - Phone:918-502-5975
Practice Address - Fax:918-502-5980
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECPED4457224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist