Individual
MS. JEANNEAN JOY JENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
900 17TH ST, WOODWARD, OK 73801-2448
(580) 256-5511
Mailing address
114 SIERRA TRL, JUSTIN, TX 76247-7022
(817) 734-6446
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041139679
IL
367500000X
Certified Registered Nurse Anesthetist
121295A
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
415154
TX
367500000X
Certified Registered Nurse Anesthetist
APN0000011461
TN
367500000X
Certified Registered Nurse Anesthetist
R0081277
OK
367500000X
Certified Registered Nurse Anesthetist
R56982
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0887119 02
—
TX
05
—
088711911
—
TX
05
—
088711913
—
TX
01
—
85969U
BCBS
TX
01
—
8765UC
BCBS
TX
01
—
P01069442
RAILROAD MEDICARE
TX
Enumeration date
04/25/2006
Last updated
03/27/2018
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