Provider Demographics
NPI:1932772035
Name:OSIFE, JENNIFER DAWN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAWN
Last Name:OSIFE
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 1:36609 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-8882
Mailing Address - Country:US
Mailing Address - Phone:405-273-1170
Mailing Address - Fax:405-275-5132
Practice Address - Street 1:36609 45TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-8882
Practice Address - Country:US
Practice Address - Phone:405-273-1170
Practice Address - Fax:405-275-5132
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No175T00000XOther Service ProvidersPeer Specialist