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Individual

MR. BRYAN F JERNIGAN II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-0612
Mailing address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
11707
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
M127354
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3631357
TN
Enumeration date
12/19/2005
Last updated
03/11/2021
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