Provider Demographics
NPI:1255589974
Name:BORGSMILLER, KELLEY K (CST/CFA)
Entity type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:K
Last Name:BORGSMILLER
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767A S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3302
Mailing Address - Country:US
Mailing Address - Phone:918-492-7587
Mailing Address - Fax:918-491-3542
Practice Address - Street 1:6767A S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3302
Practice Address - Country:US
Practice Address - Phone:918-492-7587
Practice Address - Fax:918-491-3542
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant