Healthcare Provider Details

I. General information

NPI: 1669384541
Provider Name (Legal Business Name): JAMIE TERRELL NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 E SOUTH LAKE VIEW LN
MUSTANG OK
73064-6818
US

IV. Provider business mailing address

2108 E SOUTH LAKE VIEW LN
MUSTANG OK
73064-6818
US

V. Phone/Fax

Practice location:
  • Phone: 405-640-8801
  • Fax:
Mailing address:
  • Phone: 405-640-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4246285
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: