Individual provider · Type 1 NPI

Jesse Gray Kostal

Student in an Organized Health Care Education/Training Program · Tulsa, OK

NPI number 1720832017 Active

Practice location

4502 E 41st St
Tulsa, OK 74135-2536

Call (918) 619-4400 Map

Fax (918) 619-4334

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1720832017

Jesse Gray Kostal's National Provider Identifier is 1720832017, issued on Apr 15, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tulsa, OK. The record was last updated on Apr 15, 2024.