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General NPI Number Information
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NPI Number | 1780081380
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Entity Type | Individual
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Provider Name | JILL SUZANNE RENFRO APRN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 4606 S GARNETT RD STE 110
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City | TULSA
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State | OK
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Zip | 74146-5216
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Country | US
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Telephone | 918-927-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W 7TH ST STE 2520
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City | TULSA
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State | OK
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Zip | 74119-1104
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Country | US
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Telephone | 918-579-3826
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 84804
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License Number State | OK
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