Provider Demographics
NPI:1003095183
Name:PIMENTEL, JENNIFER CHRISTA (ARNP, CPNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CHRISTA
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:ARNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 S YALE AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8303
Mailing Address - Country:US
Mailing Address - Phone:918-392-4550
Mailing Address - Fax:918-392-4551
Practice Address - Street 1:6565 S YALE AVE STE 209
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8303
Practice Address - Country:US
Practice Address - Phone:918-392-4550
Practice Address - Fax:918-392-4551
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0081020363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics