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General NPI Number Information
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NPI Number | 1811364789
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Entity Type | Individual
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Provider Name | JEANIE HUFSTETLER
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Gender | Female
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 6333 E SKELLY DR
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City | TULSA
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State | OK
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Zip | 74135-6106
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Country | US
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Telephone | 918-664-4224
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Fax | 918-663-0203
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Provider Business Mailing Address
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Address Line | 409 W 35TH PL
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City | SAND SPRINGS
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State | OK
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Zip | 74063-2856
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Country | US
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Telephone | 918-779-7177
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Fax | 918-663-0203
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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