Healthcare Provider Details

I. General information

NPI: 1063828945
Provider Name (Legal Business Name): JASMINE STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3606 N M.L.K. JR BLVD,
TULSA OK
74126
US

IV. Provider business mailing address

511 E OKLAHOMA PL
TULSA OK
74106-4828
US

V. Phone/Fax

Practice location:
  • Phone: 918-804-8417
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: