Provider Demographics
NPI:1013422310
Name:JONES, JESSICA RAYLEEN (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAYLEEN
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TERRA DR
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-9596
Mailing Address - Country:US
Mailing Address - Phone:580-290-1810
Mailing Address - Fax:833-307-1865
Practice Address - Street 1:1000 TERRA DR
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-9596
Practice Address - Country:US
Practice Address - Phone:580-290-1810
Practice Address - Fax:833-307-1865
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993598-NP363LF0000X
OK203872363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily