Individual
KYLEA CAROLINE BASDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2362
Mailing address
4502 E 41ST ST, TULSA, OK 74135-2536
(918) 660-3842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5178
OK
Other
Enumeration date
08/26/2021
Last updated
02/05/2024
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