Green, Jodie Jane

Green, Jodie Jane is an individual health care provider with primary practice located at 1501A E Wade Watts Ave , Mcalester OK 74501-5651. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Green, Jodie Jane can be contacted via phone (918) 302-0900.

Contact Information

Primary practice address
1501A E Wade Watts Ave Mcalester OK 74501-5651
Phone: (918) 302-0900
Fax: (918) 302-0929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R0073757 Oklahoma

Profile Details

NPI number 1124278585
LBN Legal business name Green, Jodie Jane
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2008
Last updated Feb 17th, 2011 - about 15 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 1124278585 NPPES
Oklahoma MEDICAID 200219910A

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