Provider Demographics
NPI:1730826959
Name:MICHELSEN, KATELYN ANN
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANN
Last Name:MICHELSEN
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 1:31 IRISH MOSS PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6609
Mailing Address - Country:US
Mailing Address - Phone:832-577-6248
Mailing Address - Fax:
Practice Address - Street 1:608 NW 9TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1015
Practice Address - Country:US
Practice Address - Phone:405-231-3000
Practice Address - Fax:405-231-3073
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program