Individual provider · Type 1 NPI

Matthew Thomas Kelly

Student in an Organized Health Care Education/Training Program · Edmond, OK

NPI number 1104717750 Active

Practice location

2709 NW 159th St
Edmond, OK 73013-1231

Call (405) 696-3440 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104717750

Matthew Thomas Kelly's National Provider Identifier is 1104717750, issued on Jul 11, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Edmond, OK. The record was last updated on Jul 11, 2025.