Provider Demographics
NPI:1316378433
Name:WEBB, JENNIFER (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 N SHARTEL AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2435
Mailing Address - Country:US
Mailing Address - Phone:405-232-8003
Mailing Address - Fax:405-278-7831
Practice Address - Street 1:1226 N SHARTEL AVE STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2435
Practice Address - Country:US
Practice Address - Phone:405-232-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-30
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200624270AMedicaid