Individual
JAMIE PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS, CM 1
Contact information
Practice address
6100 S. WALKER AVE., OKLAHOMA CITY, OK 73139
(405) 634-4400
Mailing address
6100 S WALKER AVE, OKLAHOMA CITY, OK 73139-7026
(405) 634-4400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
1124909122
OK
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
09/08/2025
Last updated
07/15/2026
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