| Doctor Name: | MRS. JAMIE TENILLE EDMINSTEN |
| NPI Number: | 1003955170 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | APA1602 |
| Business Practice Address: | 3650 W Rock Creek Rd Norman, OK - 730722202 |
| Business Phone Number: | 4053642666 |
| Business Fax Number: | 4053649627 |
| Mailing Address: | 4200 W Memorial Rd, Suite 606 OKLAHOMA CITY |
| State: | OK |
| Postal Code: | 731209350 |
| Phone Number: | 4057551930 |
| Fax Number: | |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 04/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | APA1602 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |