CROSS, CARRIE IRENE - Licensee Information

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

CROSS, CARRIE IRENE

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 CLINIC PRIMARY CARE JENKS 220 S ELM ST SUITE 200 JENKS OK 74037 Address last updated on 8/22/2024
Phone #:	(918) 403-7144
Fax #:
County:	TULSA
License:	2622
Dated:	1/14/2016
Expires:	3/31/2025
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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.

Locations:	Hours:	Languages:
ST JOHN CLINIC PRIMARY CARE JENKS 220 S ELM ST SUITE 200 JENKS OK 74037 Phone #: (918) 403-7144 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
THERON BLISS	DO	4618
JEFFREY BRIAN CRAIG	MD	27305
CYNTHIA ANN MALOY	MD	17295
Jeremy Ransdell	DO	6042

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