Misthaven, Jesse

Misthaven, Jesse is an individual health care provider with primary practice located at 6333 E Skelly Dr , Tulsa OK 74135-6106. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent, which is considered as her primary health care specialty. Misthaven, Jesse can be contacted via phone (918) 664-4224.

Contact Information

Primary practice address
6333 E Skelly Dr Tulsa OK 74135-6106
Phone: (918) 664-4224
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent 163WP0807X 99598 Oklahoma

Profile Details

NPI number 1720685175
LBN Legal business name Misthaven, Jesse
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2020
Last updated Oct 7th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720685175 NPPES
Oklahoma MEDICAID RN

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