Healthcare Provider Details

I. General information

NPI: 1265494066
Provider Name (Legal Business Name): JENNIFER L WEIGEL APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER W EL RHOUAOUI

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 S UTICA AVE SUITE 300
TULSA OK
74104-4243
US

IV. Provider business mailing address

9228 S MINGO RD STE 200
TULSA OK
74133-5722
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax: 918-592-1021
Mailing address:
  • Phone: 918-592-0999
  • Fax: 918-592-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR0067094
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberR0067094
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number67094
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: