Provider Demographics
NPI:1922101054
Name:HORSLEY, JENNIFER L (APRN-CNP,BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:HORSLEY
Suffix:
Gender:F
Credentials:APRN-CNP,BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:ZACHARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3309
Mailing Address - Country:US
Mailing Address - Phone:580-816-4050
Mailing Address - Fax:580-772-2465
Practice Address - Street 1:3701 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3309
Practice Address - Country:US
Practice Address - Phone:580-816-4050
Practice Address - Fax:580-772-2465
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK03848090163WP0808X
OKR0074918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200455210AMedicaid
OK0384090OtherPSYCHIATRIC & MENTAL HEALTH NURSE