RANDOLPH, JESSICA MICHELE - Licensee Information

Search Results

Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

RANDOLPH, JESSICA MICHELE

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:	CHEROKEE NATION OUTPATIENT CLINIC 19600 E ROSS ST TAHLEQUAH OK 74464 Address last updated on 3/26/2024
Phone #:	(539) 234-3542
Fax #:	(539) 234-3580
County:	CHEROKEE
License:	3205
Dated:	5/29/2020
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:
CHEROKEE NATION OUTPATIENT CLINIC 19600 E ROSS ST TAHLEQUAH OK 74464 Phone #: (539) 234-3542 Fax #: (539) 234-3580

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
STEPHN DRYWATER	MD	30727
JERROD DOUGLAS SPRING	MD	30005

Return to Search Licensees page