Provider Demographics
NPI:1497551402
Name:JONES, SAMANTHA (HEALTH COACH)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3481
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74013-3481
Mailing Address - Country:US
Mailing Address - Phone:918-625-2873
Mailing Address - Fax:
Practice Address - Street 1:17209 E 110TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-6041
Practice Address - Country:US
Practice Address - Phone:918-625-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach