Provider Demographics
NPI:1417493636
Name:JONES, LYNDSEY RYAN (APRN)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:RYAN
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:RYAN
Other - Last Name:TILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10021 RED FOX DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-2892
Mailing Address - Country:US
Mailing Address - Phone:405-450-7167
Mailing Address - Fax:405-289-7469
Practice Address - Street 1:3555 NW 58TH ST STE 140-W
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4707
Practice Address - Country:US
Practice Address - Phone:405-596-1525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK104718163W00000X, 363LP0808X
OKR0104718363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse