Individual
JASON P WHITELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-6100
Mailing address
316 E 123RD CT S, JENKS, OK 74037-4296
(806) 236-3080
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
645507
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002466302
—
TX
Enumeration date
07/26/2006
Last updated
03/24/2009
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