Jennifer Lynn Black, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

107607 Issued in OK

Practice address

24919 S 4420 Road
Vinita, OK 74301

Phone

(918) 256-9210

Fax

(918) 256-6356

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1336740786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24919 S 4420 ROAD",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "74301",
            "telephone_number": "918-256-9210",
            "fax_number": "918-256-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24919 S 4420 ROAD",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "74301",
            "telephone_number": "918-256-9210",
            "fax_number": "918-256-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "107607",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Leeann Bigeagle
• Elisabeth Tenneh Bimba
• Leslie Wayne Bingham
• Allegra Riley Desiree Birdwell
• Tiffany R Bishop
• Jonessa Blackfox, LPN
• Francis Rollin Bland, M.D.
• Brianna Elaina Bloom
• Jeanette Bolte
• Angela Boston, PHARM D.

• Registered Nurse in Vinita, OK
• Providers in Vinita, OK by specialty
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.