Healthcare Provider Details

I. General information

NPI: 1992693741
Provider Name (Legal Business Name): JENNIFER TUGWELL BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12192 N 179TH EAST AVE
COLLINSVILLE OK
74021-6259
US

IV. Provider business mailing address

12192 N 179TH EAST AVE
COLLINSVILLE OK
74021-6259
US

V. Phone/Fax

Practice location:
  • Phone: 918-815-0946
  • Fax:
Mailing address:
  • Phone: 918-815-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number230257
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: