Individual
KELSEA RAE SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6120 S YALE AVE STE 1210, TULSA, OK 74136-4234
(918) 888-5211
Mailing address
341 NE 4TH ST, OKLAHOMA CITY, OK 73104-4027
(405) 693-4493
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0131794
OK
363LA2100X
Acute Care Nurse Practitioner
R0131794
OK
Other
Enumeration date
05/15/2024
Last updated
03/11/2026
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