Individual
JEREAN MOSQUITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10212 E 41ST ST, TULSA, OK 74146-3703
(918) 960-7852
Mailing address
19135 BALD HILL RD, OKMULGEE, OK 74447-9399
(918) 777-8136
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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