Individual
KELLY LYNN BIRDSHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 W 3RD ST, ELK CITY, OK 73644-4323
(405) 424-7711
Mailing address
408 KIMBERLY DR, ELK CITY, OK 73644-4808
(580) 243-2700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/13/2012
Last updated
08/26/2025
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