Provider Demographics
NPI:1962184432
Name:MCGEE, JOHNIESHA (COMMUNITY BASED DOUA)
Entity type:Individual
Prefix:
First Name:JOHNIESHA
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:COMMUNITY BASED DOUA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 S 129TH EAST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-3215
Mailing Address - Country:US
Mailing Address - Phone:918-884-7550
Mailing Address - Fax:
Practice Address - Street 1:5200 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7451
Practice Address - Country:US
Practice Address - Phone:918-884-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty