| Doctor Name: | JILLENE MARIE SROCZYNSKI |
| NPI Number: | 1568877793 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BSN |
| License Number: | 113139 |
| Business Practice Address: | 1400 E Eagle Nest Ter Mustang, OK - 730649442 |
| Business Phone Number: | 4058128719 |
| Business Fax Number: | |
| Mailing Address: | 1400 E Eagle Nest Ter, MUSTANG |
| State: | OK |
| Postal Code: | 730649442 |
| Phone Number: | 4058128719 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2014 |
| NPI Last Update Date: | 06/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0200X |
| License Number: | 113139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | |