Healthcare Provider Details

I. General information

NPI: 1962287110
Provider Name (Legal Business Name): JAZMINE MARIE HOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 E 41ST ST
TULSA OK
74135-2536
US

IV. Provider business mailing address

4502 E 41ST ST
TULSA OK
74135-2536
US

V. Phone/Fax

Practice location:
  • Phone: 741-359-1866
  • Fax:
Mailing address:
  • Phone: 918-660-3842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2025052181
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: