Provider Demographics
NPI:1851999031
Name:FOREMAN, JAH'NI ANAYA
Entity Type:Individual
Prefix:
First Name:JAH'NI
Middle Name:ANAYA
Last Name:FOREMAN
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 1:1135 E BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3429
Mailing Address - Country:US
Mailing Address - Phone:405-340-1119
Mailing Address - Fax:
Practice Address - Street 1:1135 E BROOKS ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-3429
Practice Address - Country:US
Practice Address - Phone:405-340-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty