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Individual

MRS. PATTI DENISE WHEATON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, ARNP

Contact information

Practice address
1239 W MAIN ST, JENKS, OK 74037-2311
(918) 291-0004
(918) 296-3911
Mailing address
1239 W MAIN ST, JENKS, OK 74037-2311
(918) 291-0004
(918) 296-3911

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0049248
OK
363LW0102X
Women's Health Nurse Practitioner
R0049248
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200003840
OK
Enumeration date
10/06/2006
Last updated
01/06/2011
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