Individual
JENNIFER L. RAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8509 S FIR AVE, BROKEN ARROW, OK 74011-1220
(918) 286-0412
Mailing address
PO BOX 22063, DEPT 0491, TULSA, OK 74121-2063
(405) 751-4554
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1566
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108800A
—
OK
Enumeration date
12/16/2006
Last updated
11/03/2008
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