Provider Demographics
NPI:1275883134
Name:JEFFCOAT, MARQUIS MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARQUIS
Middle Name:MARIE
Last Name:JEFFCOAT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARQUIS
Other - Middle Name:MARIE
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:10309 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-627-5574
Mailing Address - Fax:405-603-8665
Practice Address - Street 1:200 N BRYANT AVE STE 120
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6273
Practice Address - Country:US
Practice Address - Phone:405-832-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK93729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily