Healthcare Provider Details

I. General information

NPI: 1790619443
Provider Name (Legal Business Name): HIBA JAMEEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5916 N PENNSYLVANIA AVE APT 221B
OKLAHOMA CITY OK
73112-7480
US

IV. Provider business mailing address

5916 N PENNSYLVANIA AVE APT 221B
OKLAHOMA CITY OK
73112-7480
US

V. Phone/Fax

Practice location:
  • Phone: 405-414-2857
  • Fax:
Mailing address:
  • Phone: 405-414-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: