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General NPI Number Information
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NPI Number | 1164363289
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Entity Type | Individual
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Provider Name | JADE GREATHOUSE
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 10109 E 79TH ST
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City | TULSA
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State | OK
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Zip | 74133-4682
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Country | US
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Telephone | 918-233-9550
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Fax | 918-756-1732
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Provider Business Mailing Address
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Address Line | 10109 E 79TH ST
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City | TULSA
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State | OK
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Zip | 74133-4682
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Country | US
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Telephone | 918-233-9550
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Fax | 918-756-1732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | R0134607
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License Number State | OK
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