Provider Demographics
NPI:1831715945
Name:MCELWEE, KYNDELL LEIGH
Entity type:Individual
Prefix:
First Name:KYNDELL
Middle Name:LEIGH
Last Name:MCELWEE
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 1:5043 S 76TH EAST AVE APT B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-6219
Mailing Address - Country:US
Mailing Address - Phone:918-688-6673
Mailing Address - Fax:
Practice Address - Street 1:5043 S 76TH EAST AVE APT B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6219
Practice Address - Country:US
Practice Address - Phone:918-688-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist