Individual
JENNE DEANN GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
1105 SW 30TH CT, MOORE, OK 73160-2887
(405) 378-2727
Mailing address
1105 SW 30TH CT, MOORE, OK 73160-2887
(405) 378-2727
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
105924
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
225001
OK
Other
Enumeration date
04/23/2019
Last updated
02/12/2026
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