Provider Demographics
NPI:1811504038
Name:GIGLIO, RITA JANE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:JANE
Last Name:GIGLIO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 N FLORENCE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3159
Mailing Address - Country:US
Mailing Address - Phone:918-608-0380
Mailing Address - Fax:417-350-1935
Practice Address - Street 1:1402 N FLORENCE AVE STE B
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3159
Practice Address - Country:US
Practice Address - Phone:918-608-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020032738363LP0808X
OK211306363LP0808X
AR217763363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR267690758Medicaid
KS201313840Medicaid
OK200949880AMedicaid
MO490098172Medicaid