Odell-Miller, Jackie Jene

Odell-Miller, Jackie Jene is an individual health care provider with primary practice located at 15951 Little Axe Dr , Norman OK 73026-9088. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Odell-Miller, Jackie Jene can be contacted via phone (405) 447-0300.

Contact Information

Primary practice address
15951 Little Axe Dr Norman OK 73026-9088
Phone: (405) 447-0300
Fax: (405) 701-7914
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R0044689 Oklahoma

Profile Details

NPI number 1427125194
LBN Legal business name Odell-Miller, Jackie Jene
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Feb 4th, 2013 - about 11 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 1427125194 NPPES
Oklahoma MEDICAID 200100070A
Oklahoma Other R0044689

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