Provider Demographics
NPI:1942362686
Name:JAMISON, JOAN LEE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LEE
Last Name:JAMISON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-5711
Mailing Address - Country:US
Mailing Address - Phone:405-425-4417
Mailing Address - Fax:405-943-9885
Practice Address - Street 1:4330 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-5711
Practice Address - Country:US
Practice Address - Phone:405-425-4417
Practice Address - Fax:405-943-9885
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0029331363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health