Jacklyn D Rose (NPI# 1700364387, PAC ID# 6002168382) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1700364387 |
| PAC ID by PECOS | 6002168382 |
| Professional Enrollment ID | I20181015003094 |
| Full Name | Jacklyn D Rose |
| Organization Legal Name | PROPHYLAXIS HEALTHCARE LLC |
| Address |
303 E Taft Ave 3 Axis Healthcare Sapulpa Sapulpa OK 74066-5651 |
| Phone Number | 9182242222 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3072784289 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 303 E Taft Ave, 3 Axis Healthcare Sapulpa, Sapulpa, OK 74066-5651 | 9182242222 | PROPHYLAXIS HEALTHCARE LLC |
| Organization Legal Name | PROPHYLAXIS HEALTHCARE LLC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brenda L Hayman-hensley | Physician Assistant | Prophylaxis Healthcare LLC | 5505 E 51st St, Tulsa, OK 74135-7468 |
| James M Lackey | Family Medicine | Prophylaxis Healthcare LLC | 23 W Commercial St, Axis Healthcare Inola, Inola, OK 74036-3606 |
| John P Watson | Nurse Practitioner | Prophylaxis Healthcare LLC | 211 S Mill St, Axis Healthcare Pryor 2, Pryor, OK 74361-5221 |
| Bret A Hubbard | Family Medicine | Prophylaxis Healthcare LLC | 11911 S Memorial Dr, Axis Healthcare Bixby, Bixby, OK 74008-2030 |
| Tony Ho | Family Medicine | Prophylaxis Healthcare LLC | 303 E Taft Ave, 3 Axis Healthcare Sapulpa, Sapulpa, OK 74066-5651 |
| Mary W Martin | Obstetrics/gynecology | Prophylaxis Healthcare LLC | 2431 Se Washington Blvd B, Axis Healthcare Bartlesville, Bartlesville, OK 74006-7259 |
| David Chorley | Family Medicine | Prophylaxis Healthcare LLC | 11911 S Memorial Dr, Axis Healthcare Bixby, Bixby, OK 74008-2030 |
| Robert E Mitchell | Plastic and Reconstructive Surgery | Prophylaxis Healthcare LLC | 11911 S Memorial Dr, Axis Healthcare Bixby, Bixby, OK 74008-2030 |
| Elizabeth A Lee | Physician Assistant | Prophylaxis Healthcare LLC | 2431 Se Washington Blvd B, Axis Healthcare Bartlesville, Bartlesville, OK 74006-7259 |
| Scott G Lilly | Hematology/oncology | Prophylaxis Healthcare LLC | 11911 S Memorial Dr, Axis Healthcare Bixby, Bixby, OK 74008-2030 |
| Street Address |
303 E TAFT AVE 3 AXIS HEALTHCARE SAPULPA |
| City | SAPULPA |
| State | OK |
| Zip | 74066-5651 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tony Ho | Family Medicine | Prophylaxis Healthcare LLC | 303 E Taft Ave, 3 Axis Healthcare Sapulpa, Sapulpa, OK 74066-5651 |
| Todd A Caskey | Physician Assistant | Prophylaxis Healthcare LLC | 303 E Taft Ave, 3 Axis Healthcare Sapulpa, Sapulpa, OK 74066-5651 |
| Tommy D Foreman | Family Practice | Prophylaxis Healthcare LLC | 303 E Taft Ave, 3 Axis Healthcare, Sapulpa, OK 74066-5651 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kasey M. Nichols | Chiropractic | 200 N Mission, Suite A, Sapulpa, OK 74066-3606 | |
| James Russell | Family Medicine | 308 S Main St, Sapulpa, OK 74066-4110 | |
| Kayla Warner | Nurse Practitioner | 124 E Dewey Ave, Suite A, Sapulpa, OK 74066-4204 | |
| Larry W Higgs | Optometry | Drs Higgs and Morris Optometrists Inc | 17 S Oak St, Sapulpa, OK 74066-4312 |
| Dennis M Morris | Optometry | Drs Higgs and Morris Optometrists Inc | 17 S Oak St, Sapulpa, OK 74066-4312 |
| Goldameir Akingbola | Family Medicine | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Misty Dawn Stephens | Nurse Practitioner | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Jeremy Ransdell | Family Medicine | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Jill Rae Johnson | Nurse Practitioner | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Sarah Renea Gilbert | Nurse Practitioner | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Find all physicians in zip 74066 | |||
| City | SAPULPA |
| Zip Code | 74066 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SAPULPA + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.