Provider Demographics
NPI:1831623677
Name:THELIN, JOEY DONNA (RN)
Entity type:Individual
Prefix:MS
First Name:JOEY
Middle Name:DONNA
Last Name:THELIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 E. 470 RD.
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017
Mailing Address - Country:US
Mailing Address - Phone:918-342-0770
Mailing Address - Fax:918-341-4245
Practice Address - Street 1:9435 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9047
Practice Address - Country:US
Practice Address - Phone:918-664-2200
Practice Address - Fax:918-664-3343
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0054124163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse