Provider Demographics
NPI:1841537859
Name:BIRKS, JENNY MARIE (PA)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIE
Last Name:BIRKS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:MARIE
Other - Last Name:SCHERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LD, RD
Mailing Address - Street 1:10901 E 48TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5830
Mailing Address - Country:US
Mailing Address - Phone:918-749-8765
Mailing Address - Fax:918-392-2155
Practice Address - Street 1:10901 E 48TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5830
Practice Address - Country:US
Practice Address - Phone:918-749-8765
Practice Address - Fax:918-392-2155
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant