Provider Demographics
NPI:1265325617
Name:LATZKE, KAYTEE NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:KAYTEE
Middle Name:NICOLE
Last Name:LATZKE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 STEVENS PASS
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7689
Mailing Address - Country:US
Mailing Address - Phone:405-880-0428
Mailing Address - Fax:
Practice Address - Street 1:3824 S BOULEVARD STE 110
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5779
Practice Address - Country:US
Practice Address - Phone:405-546-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6488231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist