Healthcare Provider Details

I. General information

NPI: 1487579892
Provider Name (Legal Business Name): GENEVIEVE GUTHRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N CLASSEN BLVD STE 2600
OKLAHOMA CITY OK
73106-6027
US

IV. Provider business mailing address

3134 NW EXPRESSWAY APT 271
OKLAHOMA CITY OK
73112-4051
US

V. Phone/Fax

Practice location:
  • Phone: 405-248-9200
  • Fax:
Mailing address:
  • Phone: 918-972-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberJ081088456
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: