Provider Demographics
NPI:1538481130
Name:YADON, JESSICA LEE
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEE
Last Name:YADON
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 1:1932 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6124
Mailing Address - Country:US
Mailing Address - Phone:918-521-9280
Mailing Address - Fax:
Practice Address - Street 1:24797 S HWY 66
Practice Address - Street 2:SUITE 5
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019-2411
Practice Address - Country:US
Practice Address - Phone:918-342-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator