Provider Demographics
NPI:1952648891
Name:BAXTER, KALEE MARIE
Entity Type:Individual
Prefix:MRS
First Name:KALEE
Middle Name:MARIE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KALEE
Other - Middle Name:MARIE
Other - Last Name:WEGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 N HIGHLAND ST APT B
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-2405
Mailing Address - Country:US
Mailing Address - Phone:580-453-1339
Mailing Address - Fax:
Practice Address - Street 1:1025 N HIGHLAND ST APT B
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-2405
Practice Address - Country:US
Practice Address - Phone:580-453-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator