Provider Demographics
NPI:1811588809
Name:LEMON, JENNIFER LYNN PURSELL (MED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN PURSELL
Last Name:LEMON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYN PURSELL
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:7510 BROADWAY EXT STE 205
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-9031
Mailing Address - Country:US
Mailing Address - Phone:405-418-8522
Mailing Address - Fax:
Practice Address - Street 1:4450 BUFFALO HL
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-9511
Practice Address - Country:US
Practice Address - Phone:405-418-8522
Practice Address - Fax:405-418-8665
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator