Healthcare Provider Details

I. General information

NPI: 1285546879
Provider Name (Legal Business Name): JENNIFER STEWART RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 S UTICA AVE
TULSA OK
74104-6520
US

IV. Provider business mailing address

11211 N 132ND EAST AVE
OWASSO OK
74055-5675
US

V. Phone/Fax

Practice location:
  • Phone: 918-744-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number149114
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: