Provider Demographics
NPI:1093199721
Name:JAMISON, FLORAME (APRN)
Entity Type:Individual
Prefix:
First Name:FLORAME
Middle Name:
Last Name:JAMISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1373 E BOONE ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-3365
Mailing Address - Country:US
Mailing Address - Phone:918-207-1189
Mailing Address - Fax:
Practice Address - Street 1:1373 E BOONE ST STE 1201
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3365
Practice Address - Country:US
Practice Address - Phone:918-207-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily