Provider Demographics
NPI:1669940300
Name:THOMAS, JANA LYNNE
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:LYNNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:LYNNE
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:508 W VANDAMENT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4665
Mailing Address - Country:US
Mailing Address - Phone:405-350-8100
Mailing Address - Fax:405-212-4480
Practice Address - Street 1:1900 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5427
Practice Address - Country:US
Practice Address - Phone:405-295-2900
Practice Address - Fax:405-212-4480
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK58433363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily