Provider Demographics
NPI:1497974281
Name:JESTER, JAMIE CLAIRE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:CLAIRE
Last Name:JESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1354
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-1354
Mailing Address - Country:US
Mailing Address - Phone:580-716-1032
Mailing Address - Fax:
Practice Address - Street 1:4720 S SHIELDS BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-3210
Practice Address - Country:US
Practice Address - Phone:405-632-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator