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NPI Code Detail

MEDICARE: JENNA CARTER

MEDICARE: JENNA CARTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianOK

General Provider Information

NPI Number : 1023891280
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA CARTER
Provider Business Mailing Address
First Line : 15201A CROWN AT LONE OAK RD
Second Line :
City : EDMOND
State : OK
Zip : 73013-2272
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15201A CROWN AT LONE OAK RD
Second Line :
City : EDMOND
State : OK
Zip : 73013-2272
Country : US
Telephone Number : 479-268-4515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ JENNA CARTER ” Practice Location

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