Provider Demographics
NPI:1285466425
Name:ZENTENO, YESSENIA ISABELLE
Entity type:Individual
Prefix:
First Name:YESSENIA
Middle Name:ISABELLE
Last Name:ZENTENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8445 S PUSH COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-2316
Mailing Address - Country:US
Mailing Address - Phone:469-441-7986
Mailing Address - Fax:
Practice Address - Street 1:8445 S PUSH COUNTY RD
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2316
Practice Address - Country:US
Practice Address - Phone:469-441-7986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0134455163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine