Provider Demographics
NPI:1396045753
Name:GELINAS, JOSEPH JAMES (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JAMES
Last Name:GELINAS
Suffix:
Gender:M
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 1:62500 E 247 LOOP
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-7435
Mailing Address - Country:US
Mailing Address - Phone:918-786-0800
Mailing Address - Fax:918-786-0876
Practice Address - Street 1:601 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-3429
Practice Address - Country:US
Practice Address - Phone:918-786-0800
Practice Address - Fax:918-786-0876
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80573363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200313460AMedicaid
OK200505990BMedicaid
OK299061YKW9Medicare PIN
OK200313460AMedicaid
OK100747570AMedicaid
OKDC3959Medicare PIN