Provider Demographics
NPI:1043329816
Name:HAMIL, JENNIFER LYN (RN,MS,ARNP,CNP,APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:HAMIL
Suffix:
Gender:F
Credentials:RN,MS,ARNP,CNP,APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:HAVENS
Other - Last Name:ZAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MSN,ARNP,CNP,APRN
Mailing Address - Street 1:PO BOX 740020
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0020
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:1538 N LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-2535
Practice Address - Country:US
Practice Address - Phone:918-400-7001
Practice Address - Fax:539-202-5070
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0046099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK760639661-012OtherBCBSOK