Most Relevant Information
Provider Data
| NPI Number: | 1003531211 |
| Provider Name: | JEANNIE ROSE TALLBEAR APRN-CNP, PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 210525 |
Most Important Dates
| Enumeration Date: | 10/10/2022 |
| Last Updated: | 12/16/2022 |
Provider Practice Location
1491 S SUNNYLANE RD
DEL CITY
OK
731153037
Practice Location Phone/Fax
| Phone: | 4054334470 |
| Fax: |
Provider Mailing Location
1491 S SUNNYLANE RD
DEL CITY
OK
731153037
Provider Mailing Phone/Fax
| Phone: | 4054372240 |
| Fax: | 6612313153 |