Healthcare Provider Details

I. General information

NPI: 1043090103
Provider Name (Legal Business Name): JENNIFER RUTH RHINE APRN-CNP, PMHNP,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER RUTH COOPER

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 S GARNETT RD
TULSA OK
74146-5222
US

IV. Provider business mailing address

4750 S GARNETT RD
TULSA OK
74146-5222
US

V. Phone/Fax

Practice location:
  • Phone: 539-812-2100
  • Fax: 800-242-5174
Mailing address:
  • Phone: 539-812-2100
  • Fax: 800-242-5174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0130893
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number216100
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: