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Jared Penner
Student in an Organized Health Care Education/Training Program in Moore, Oklahoma
NPI 1376163790

Jared Penner is a Student in an Organized Health Care Education/Training Program based in Moore, OK. Jared Penner practices in Moore, OK. The NPI Number for Jared Penner is 1376163790 and holds a License No. (Oklahoma).

The current practice location address for Jared Penner is 4209 Mackenzie Dr, Moore, OK and can be reached out via phone at 480-200-2506.

Location: 4209 Mackenzie Dr, Moore, OK, 73160-1267
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376163790
Provider Name
Jared Penner
Credential
Provider Entity Type
Individual
Gender
Male
Address
4209 Mackenzie Dr, Moore, OK, 73160-1267
Phone Number
480-200-2506
Fax Number
Provider Enumeration Date
04/26/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4209 Mackenzie Dr
City
Moore
State
Oklahoma
Zip
73160-1267
Phone Number
480-200-2506
Fax Number
person
Provider Business Mailing Address Details
Address
4209 Mackenzie Dr
City
Moore
State
Oklahoma
Zip
73160-1267
Phone Number
480-200-2506
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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