JESSICA RAE PROVOST (NPI# 1659724144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659724144 |
Entity Type | Individual |
Full Name | JESSICA RAE PROVOST |
Credential | APRN |
Practice Address |
1919 E Memorial Rd Oklahoma City OK 73131-1253 |
Practice Telephone | 4053417009 |
Practice Fax Number | 4053301811 |
Mailing Telephone | 4053417009 |
Mailing Fax Number | 4053301811 |
Enumeration Date | 2016-07-19 |
Last Update Date | 2016-10-20 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
93861 | OK | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508413493 | Jessica Provost | Dietitian, Registered | 3506 W 78th St, Prairie Village, KS 66208-4032 | 2019-08-24 |
1326242652 | Jessica E Provost | Speech-Language Pathologist | 6033 Larboard Dr., Apex, NC 27539-4115 | 2007-06-12 |
Street Address |
1919 E MEMORIAL RD |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73131-1253 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407831803 | Laboratory Corporation of America | Clinical Medical Laboratory | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2005-12-08 |
1215452107 | Richard Watkins | Registered Nurse | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2017-08-11 |
1629429386 | Jaime Dawn Martin | Nurse Practitioner | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2016-06-23 |
1124498282 | Angela C. Baustert | Nurse Practitioner | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2015-10-01 |
1902273907 | Angela Atterberry | Nurse Practitioner | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2015-08-25 |
1811382187 | Kathryn Haag | Nurse Practitioner | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2015-04-02 |
1447663281 | Erika Breedlove | Family Medicine | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2014-06-10 |
1609292523 | Megan Rachele Spradlin | Registered Nurse | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2014-03-17 |
1740621291 | Ryan Gotcher | Family Medicine | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2013-07-12 |
1235484759 | Tiffany Anne Ludwick | Physician Assistant | 1919 E Memorial Rd, Oklahoma City, OK 73131-1253 | 2012-07-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821227794 | Jennifer B Elise | Counselor | 9212 N Kelley Avenue, Oklahoma City, OK 73131 | 2009-07-13 |
1457450462 | Procare Healing Centers, LLP | Durable Medical Equipment & Medical Supplies | 2100 E Britton Rd, Oklahoma City, OK 73131 | 2006-09-22 |
1023135506 | David M. Abercrombie | Emergency Medicine | 1624 Grey Fox Run, Oklahoma City, OK 73131-1218 | 2007-03-22 |
1801295167 | Nancy Lynn Mcelveen | Counselor | 1619 Grey Fox Run, Oklahoma City, OK 73131-1219 | 2014-08-22 |
1790021780 | Dustin Neil Belden | Behavioral Analyst | 1621 Grey Fox Run, Oklahoma City, OK 73131-1219 | 2012-12-18 |
1376032722 | Emily Sue Hicks | Dietitian, Registered | 1500 Steeple Chase St, Oklahoma City, OK 73131-1222 | 2018-05-01 |
1205485802 | Kayla Matthews | Nurse Practitioner | 1810 E Memorial Rd, Oklahoma City, OK 73131-1237 | 2019-09-05 |
1659818847 | Integrated Immunology Solutions LLC | Allergy & Immunology | 1810 E Memorial Rd, Oklahoma City, OK 73131-1237 | 2017-01-25 |
1063718237 | Leslie Michele Jump | Nurse Practitioner | 1810 E Memorial Rd, Oklahoma City, OK 73131-1237 | 2011-02-04 |
1336109750 | Amy L. Darter | Allergy & Immunology | 1810 E Memorial Rd, Oklahoma City, OK 73131-1250 | 2006-03-28 |
Find all providers in zip 73131 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700483302 | Terri Lynn Quintero | Nurse Practitioner | 15701 S Pennsylvania Ave, Oklahoma City, OK 73170-8713 | 2020-10-06 |
1952917239 | Philomina Philipose | Nurse Practitioner | 8805 Nw 116th St, Oklahoma City, OK 73162-2220 | 2020-09-21 |
1376158295 | Ligi Abraham | Nurse Practitioner | 4200 W Memorial Rd Ste 206, Oklahoma City, OK 73120-8305 | 2020-09-09 |
1487266532 | Carla Jo Walker | Nurse Practitioner | 1325 N Walker Ave Apt 357, Oklahoma City, OK 73103-6409 | 2020-08-20 |
1396356143 | Deshell Ravette Tillman | Nurse Practitioner | 2621 N Sterling Ave, Oklahoma City, OK 73127-1919 | 2020-08-14 |
1225656549 | Simon Wellness LLC | Nurse Practitioner | 9321 Sw 23rd St, Oklahoma City, OK 73128-1840 | 2020-07-13 |
1831717396 | Caitlin Raylynn Stenberg | Nurse Practitioner | 1000 N Lincoln Blvd Ste 3200, Oklahoma City, OK 73104-3252 | 2020-07-10 |
1467078113 | Jaanki Bhakta | Nurse Practitioner | 9116 Sw 24th St, Oklahoma City, OK 73128-4903 | 2020-06-18 |
1629699244 | Tanya Cates | Nurse Practitioner | 5529 Bush Creek Way, Oklahoma City, OK 73117-8440 | 2020-05-05 |
1922629054 | Heather Amanda Chin Hwa Rutledge | Nurse Practitioner | 7800 Sw 87th Cir, Oklahoma City, OK 73169-7800 | 2020-04-29 |
Find all providers in OKLAHOMA CITY |
City | OKLAHOMA CITY |
Zip Code | 73131 |
Please comment or provide details below to improve the information on JESSICA RAE PROVOST.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.