Provider Demographics
NPI:1801053731
Name:JONES, PEGGY JANE (RN)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:POUND
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:4811 N ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2661
Mailing Address - Country:US
Mailing Address - Phone:405-495-1388
Mailing Address - Fax:
Practice Address - Street 1:4811 N ASBURY AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2661
Practice Address - Country:US
Practice Address - Phone:405-495-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0030934163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency