Healthcare Provider Details

I. General information

NPI: 1982537767
Provider Name (Legal Business Name): JACQUELINE ANN SAUTER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 E 31ST ST STE 1000
TULSA OK
74135-5010
US

IV. Provider business mailing address

5330 E 31ST ST STE 1000
TULSA OK
74135-5010
US

V. Phone/Fax

Practice location:
  • Phone: 918-585-1213
  • Fax: 918-585-1263
Mailing address:
  • Phone: 918-585-1213
  • Fax: 918-585-1263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number59097
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: