Individual
JACY RHAE REITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP-APRN
Contact information
Practice address
6001 NW 139TH ST STE A, OKLAHOMA CITY, OK 73142-1919
(405) 635-3511
(405) 603-2240
Mailing address
6001 NW 139TH ST STE A, OKLAHOMA CITY, OK 73142-1919
(405) 635-3511
(405) 603-2240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
204976
OK
363LF0000X
Family Nurse Practitioner
Primary
204976
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204976
NURSE PRACTITIONER LICENSE
OK
Enumeration date
08/11/2021
Last updated
08/11/2021
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