# ST JOHN HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508226507
- **Authorized official:** MS. KELLEY MICHELLE FROST MS RD LD CDE (DIABETES EDUCATOR)
- **Authorized official phone:** (918) 744-2449

## Contact information

- **Practice address:** 1717B S UTICA AVE, SUITE 205, TULSA, OK 74104-5333
- **Practice address phone:** (918) 744-2995
- **Mailing address:** 1717B S UTICA AVE, SUITE 205, TULSA, OK 74104-5333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/03/2016
- **Last updated:** 03/03/2016