Healthcare Provider Details

I. General information

NPI: 1477258580
Provider Name (Legal Business Name): JENNIFER WEBB RRT/ACCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 NW 56TH ST
OKLAHOMA CITY OK
73112-4518
US

IV. Provider business mailing address

248 WATERFRONT DR
NORMAN OK
73071-2135
US

V. Phone/Fax

Practice location:
  • Phone: 405-606-6937
  • Fax:
Mailing address:
  • Phone: 405-365-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279E0002X
TaxonomyEmergency Care Registered Respiratory Therapist
License Number2419
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number2419
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number2419
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: