Individual
KAITLIN SHIDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4624 BOULDER BRIDGE WAY, EDMOND, OK 73034-7081
(918) 408-9193
Mailing address
4624 BOULDER BRIDGE WAY, EDMOND, OK 73034-7081
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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