Provider Demographics
NPI:1942080528
Name:BROWNING, KYLE SHAYNE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:SHAYNE
Last Name:BROWNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W ARCHER ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-1807
Mailing Address - Country:US
Mailing Address - Phone:539-222-8725
Mailing Address - Fax:
Practice Address - Street 1:415 W ARCHER ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1807
Practice Address - Country:US
Practice Address - Phone:539-222-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator