DYKEMA, JENNIFER LYNN - Licensee Information

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

DYKEMA, JENNIFER LYNN

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:	INTEGRIS BAPTIST PORTLAND AVENUE HOSPITAL 5501 N PORTLAND OKLAHOMA CITY OK 73112 Address last updated on 12/2/2023
Phone #:	(405) 604-4119
Fax #:
County:	OKLAHOMA
License:	4032
Dated:	9/6/2007
Expires:	1/31/2025
Temp. Ltr. Issued:	6/15/2007
Temp. Ltr. Expires:	9/22/2007
License Type:	Physical Therapist
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

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:
INTEGRIS BAPTIST PORTLAND AVENUE HOSPITAL 5501 N PORTLAND OKLAHOMA CITY OK 73112 Phone #: (405) 604-4119 Fax #:

Name:	Type:	License Number:
Primary Supervisees(s):
LAURA ASHLEY BLALOCK	TA	3376
RANDI LEIGH BRANDT	TA	1399
MICHAEL LOUIS BRUCE	TA	2010
ANNA MARIA COSTELLO	TA	3289
ALEXANDRIA GALE GOODRICH	TA	2917
ANGELA GAYE LESTER	TA	791
ANGELA GAYE LESTER	TA	791
LESLIE HEIDI ROBERTS	TA	3050
ALLISON GRACE SJONG	TA	1189
MICHELLE CASEY TISDALE	TA	1292

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