Provider Demographics
NPI:1619622230
Name:JNKYNP, LLC.
Entity Type:Organization
Organization Name:JNKYNP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, AGNP-C
Authorized Official - Phone:405-562-3701
Mailing Address - Street 1:12220 N. MACARTHUR BLVD.
Mailing Address - Street 2:STE. F #160
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162
Mailing Address - Country:US
Mailing Address - Phone:405-562-3701
Mailing Address - Fax:405-562-6257
Practice Address - Street 1:4905 NW 155TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-9666
Practice Address - Country:US
Practice Address - Phone:405-401-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care