Individual
MRS. JILLIAN LEIGH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-0612
Mailing address
6839 S CANTON AVE, TULSA, OK 74136
(918) 494-0612
(918) 392-4693
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
146822
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
78700
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8112UD
BCBS
TX
Enumeration date
05/09/2012
Last updated
03/11/2021
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