MRS. JENA RAYLYNN-GWENDOLYN LUEKING (NPI# 1174006050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174006050 |
| Entity Type | Individual |
| Full Name | MRS. JENA RAYLYNN-GWENDOLYN LUEKING |
| Practice Address |
117 Rodgers Dr Holdenville OK 74848-2877 |
| Mailing Address |
Po Box 590 Holdenville OK 74848-0590 |
| Practice Telephone | 4053796668 |
| Mailing Telephone | 4053796668 |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
117 RODGERS DR |
| City | HOLDENVILLE |
| State | OK |
| Zip Code | 74848-2877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550359 | Terri L Ford | Case Manager/Care Coordinator | 117 Rodgers Dr, Holdenville, OK 74848-2877 | 2019-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276160 | Corner Clinic Aprn-cnp Pllc | Clinic/Center | 201 N Hinkley, Holdenville, OH 74848 | 2018-05-22 |
| 1063948230 | Savannah Ione Hartwick | Personal Emergency Response Attendant | 400 Crestview Dr., Holdenville, OK 74848 | 2017-05-10 |
| 1568910297 | Alicia Rose Gosey | Nurse Practitioner | 1011 N Hinkley St, Holdenville, OK 74848 | 2016-09-11 |
| 1649611278 | Sooner Health Services IIi, Inc. | Home Health | 106 N Broadway, Holdenville, OK 74848 | 2013-07-11 |
| 1275852089 | Jennifer Michele Gaines | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2010-05-19 |
| 1497975528 | Gloria Buenrostro Turner | Physical Therapist | Therapy Care Outpatient PC, 317 E 8th St, Holdenville, OK 74848 | 2007-04-30 |
| 1215075528 | Therapy Care Outpatient PC | Physical Therapist | 317 E 8th Street, Holdenville, OK 74848 | 2007-02-01 |
| 1285724732 | Heritage Village Nursing Center, LLC | Skilled Nursing Facility | 801 Highway #48, Holdenville, OK 74848 | 2006-10-13 |
| 1861484776 | Joseph Omer Lavalley | Dentist | 300 E Hwy, Holdenville, OK 74848 | 2005-08-17 |
| 1699150052 | Stephanie Keesee | Nurse Practitioner | 201 N Hinckley St, Holdenville, OK 74848 | 2015-07-28 |
| Find all providers in zip 74848 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306314133 | Shelley Byrd | Peer Specialist | 118 E Main St, Holdenville, OK 74848-3208 | 2018-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
| City | HOLDENVILLE |
| Zip Code | 74848 |
Please comment or provide details below to improve the information on MRS. JENA RAYLYNN-GWENDOLYN LUEKING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.