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NPI Code Detail

MEDICARE: JEANNIE LYNN LENTZ

MEDICARE: JEANNIE LYNN LENTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1194513283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNIE LYNN LENTZ
Provider Business Mailing Address
First Line : 15809 WINDSTOP CT
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-3507
Country : US
Telephone Number : 405-664-3510
Fax Number :
Provider Business Practice Location Address
First Line : 3701 E RENO AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73117-6609
Country : US
Telephone Number : 405-702-4325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2025
Last Update Date : 05/02/2025

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Directions to “ JEANNIE LYNN LENTZ ” Practice Location

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