Provider Demographics
NPI:1245037159
Name:PERKINS, JESSICA CLARISE (RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CLARISE
Last Name:PERKINS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18504 SALVADOR RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-7652
Mailing Address - Country:US
Mailing Address - Phone:479-283-9742
Mailing Address - Fax:
Practice Address - Street 1:825 NE 10TH ST # 5F
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5417
Practice Address - Country:US
Practice Address - Phone:405-271-8156
Practice Address - Fax:405-271-6452
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK221862163WU0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WU0100XNursing Service ProvidersRegistered NurseUrologyGroup - Single Specialty