Provider Demographics
NPI:1598515090
Name:JONES, KAITLYN ODENE (PRSS)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ODENE
Last Name:JONES
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7931
Mailing Address - Country:US
Mailing Address - Phone:405-459-7478
Mailing Address - Fax:
Practice Address - Street 1:2129 NW 30TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7901
Practice Address - Country:US
Practice Address - Phone:405-459-7478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist