Healthcare Provider Details

I. General information

NPI: 1841332426
Provider Name (Legal Business Name): JENNIFER LYNN TITUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNN SAXTON HARDEE

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S HARVARD AVE STE 600
TULSA OK
74114-3304
US

IV. Provider business mailing address

650 S PEORIA
TULSA OK
74120-4429
US

V. Phone/Fax

Practice location:
  • Phone: 918-582-7228
  • Fax: 918-382-1881
Mailing address:
  • Phone: 918-587-9471
  • Fax: 918-560-0137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN80062
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: