Provider Demographics
NPI:1033750328
Name:MANNS, JAZMINE DENISE NICOLE
Entity Type:Individual
Prefix:MS
First Name:JAZMINE
Middle Name:DENISE NICOLE
Last Name:MANNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-494-5300
Mailing Address - Fax:918-494-5455
Practice Address - Street 1:6151 S YALE AVE STE 1304
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1907
Practice Address - Country:US
Practice Address - Phone:918-494-5300
Practice Address - Fax:918-494-5455
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4727363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant