Roder, Jeanne Alice
Roder, Jeanne Alice is an individual health care provider with primary practice located at 525 Sw 80Th St Suite 200, Oklahoma City OK 73139. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Roder, Jeanne Alice can be contacted via phone (405) 631-0481.Contact Information
Primary practice address
525 Sw 80Th St Suite 200
Oklahoma City OK 73139
Phone: (405) 631-0481
Fax: (405) 631-9025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1115 | Oklahoma |
Profile Details
| NPI number | 1285691287 |
|---|---|
| LBN Legal business name | Roder, Jeanne Alice |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Aug 21st, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285691287 | NPPES |
| Oklahoma | MEDICAID | 100191990A | |
| Oklahoma | Other | 970018299 |
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