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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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WENGER, JILL LAUREN       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: ST JOHN PHYSICIANS INC
1705 E 19TH ST #302
TULSA OK 74104-5410

Address last updated on 8/5/2024
Phone #: (918) 748-7599
Fax #: (918) 748-7539
County: TULSA
License: 20402
Dated: 9/11/1997
Expires: 9/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 1993
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Hospice and Palliative Medicine
New Patients: No
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
CommunityCare HMO, Inc
HealthChoice
Preferred Community Choice
United Healthcare Options PPO
Hospital Privileges: Ascension St. John Medical Center
Tulsa, OK
Locations: Hours: Languages:
ST JOHN PHYSICIANS INC
1705 E 19TH ST #302
TULSA OK 74104-5410

Phone #: (918) 748-7599
Fax #: (918) 748-7539
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMY MARIE CAMPBELL PA 2013
ERIN MARIE CAPPS PA 2074
JAYNE ELIZABETH CONTRERAS PA 2103
NANDINI ASNANI DHAMEJA PA 2919
CINDY LEE DUNLAP PA 2075
KAYLYNN COATS ELMORE PA 1953
MINI GEORGE PA 1334
LAURA KATHRYN HOLMAN PA 2726
MARTHA KELLY-LEGLER APRN 10405
KELSEY NICOLE KLEIN PA 2391
JENNIFER RENEE MEANS PA 2084
DAVID JOSEPH OLSON PA 2248
ANITA RAQUEL RAMIREZ PA 3165
LEONARDO RAUCH PA 1733
SHAYNIEL STEARS PA 2708
RICHELLE CHRISTINE VOTH PA 2427

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