Basic Information
| Provider Information | |||||||||
| NPI: | 1164921367 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZENTNER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11700 NW 135TH ST | ||||||||
| Address2: | |||||||||
| City: | PIEDMONT | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730786202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053080104 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4120 W MEMORIAL RD | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731209320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053022661 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2018 | ||||||||
| LastUpdateDate: | 03/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 102288 | OK | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 102288 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.