JESSE MISTHAVEN


Address: 6333 E Skelly Dr, Tulsa, OK 74135-6106
Phone: 9186644224

JESSE MISTHAVEN (NPI# 1720685175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720685175
Entity Type Individual
Full Name JESSE MISTHAVEN
Credential RN
Practice Address 6333 E Skelly Dr
Tulsa
OK 74135-6106
Practice Telephone 9186644224
Mailing Telephone 9186644224
Enumeration Date 2020-10-07
Last Update Date 2020-10-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WP0807X Registered Nurse
Specialization: Psych/Mental Health, Child & Adolescent
99598 OK Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OK RN 05

Office Location

Street Address 6333 E SKELLY DR
City TULSA
State OK
Zip Code 74135-6106

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053317883 12 & 12, Inc. Substance Abuse Rehabilitation Facility 6333 E Skelly Dr, Tulsa, OK 74135-6106 2005-06-27
1699372482 Christine Reynold Registered Nurse 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-10-05
1679185920 Kacey Ann Cottrell Registered Nurse 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-08-18
1861003931 Matthew Schane Case Manager/Care Coordinator 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-08-12
1841817368 Bernadette Bouciquot Registered Nurse 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-06-30
1568088011 Brenda Kay Kuntzelman Licensed Practical Nurse 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-06-21
1023634698 Kelli Ann Ordorica Case Manager/Care Coordinator 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-06-19
1215552120 Amanda Lindsey Spicer Case Manager/Care Coordinator 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-06-16
1619592672 Tieraney Candice Rodriguez Case Manager/Care Coordinator 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-06-15
1043846447 Meghan R Comer Case Manager/Care Coordinator 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-03-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437761590 Dr. Whitney M. Ellsworth, Dpt, Pllc Physical Therapist 4185 S Harvard Ave, Suite E-1, Tulsa, OK 74135 2020-08-20
1942839089 Kimberly Renee Gillens Student in an Organized Health Care Education/Training Program 4502 E 41st Street Obgyn Department, Tulsa, OK 74135 2020-04-01
1528525524 Everest Pain Management Clinic/Center 4134 S Harvard Ave Suite B1, Tulsa, OK 74135 2019-02-26
1326524216 Shelley Deeann Anderson Technician 7359 S 68th, Tulsa, OK 74135 2018-07-14
1811489065 Taylor Diane Spears Behavioral Analyst 4835 S Fulton Ave Suite 104, Tulsa, OK 74135 2018-06-04
1225547821 Heather Nicole Freed Counselor 4363 S Harvard Ave, Tulsa, OK 74135 2017-09-26
1306363924 Danielle Walker Case Manager/Care Coordinator 3244 S Lakewood Ave Apt 4e, Tulsa, OK 74135 2017-08-24
1346766078 Angels Place Day Training, Developmentally Disabled Services 3919 S. Oswego Avenue, Tulsa, OK 74135 2017-08-15
1659800019 Welena-phay Kamamma Boren Counselor 4636 S Harvard Avenue, Tulsa, OK 74135 2017-06-08
1346774197 Brandie Herren Registered Nurse 6333 E Skelly Drive, Tulsa, OK 74135 2017-04-19
Find all providers in zip 74135

Taxonomy Information

Taxonomy Code 163WP0807X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health, Child & Adolescent

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699372482 Christine Reynold Registered Nurse 6333 E Skelly Dr, Tulsa, OK 74135-6106 2020-10-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1629553771 Cierra Chapa Registered Nurse 600 S. Choctaw, El Reno, OK 73036 2018-09-25
1053817775 Emilia Sue Lopez Registered Nurse 2008 East 2110 Road, Hugo, OK 74743 2018-04-02
1265514616 Theresa Marie Hanus Registered Nurse 250 Henry St, Delaware, OK 43015 2006-10-19
1417503038 Amy Melissa Fleming Registered Nurse 1707 Professional Cir, Yukon, OK 73099-6470 2019-08-11
1427613488 Robin Marie Lacy Registered Nurse 1707 Professional Cir, Yukon, OK 73099-6470 2019-05-06
1558725713 Ashley Lee Registered Nurse 3400 Deskin Dr, Norman, OK 73069-8295 2016-04-13
1699132126 Kelly Nix Registered Nurse 400 N Broadway St, Moore, OK 73160-4812 2016-01-28
1255704821 Lisa Lumry Registered Nurse 3400 Deskin Dr, Norman, OK 73069-8295 2015-11-04
1669883781 Connie Jo Johnson Registered Nurse 2601 Spencer Rd, Spencer, OK 73084-3649 2014-05-12
1629320890 Tara Herren Registered Nurse 7908 Nw 23rd St, Bethany, OK 73008-4950 2012-10-11
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Competitor

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City TULSA
Zip Code 74135

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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