Individual
MRS. JESSICA TOMPKINS WIEDUWILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
920 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5036
(405) 271-4351
(405) 271-8695
Mailing address
PO BOX 26901, OKLAHOMA CITY, OK 73126-0901
(405) 271-4351
(405) 271-8695
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
688535
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
202035
OK
367500000X
Certified Registered Nurse Anesthetist
3885
CA
Other
Enumeration date
11/20/2009
Last updated
01/28/2022
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