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NPI Code Detail

MEDICARE: MRS. JERRI DILLON RN

MEDICARE:  MRS. JERRI  DILLON  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR0060820OK

General Provider Information

NPI Number : 1760871354
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JERRI DILLON RN
Provider Business Mailing Address
First Line : 2023 E 13TH PL
Second Line :
City : TULSA
State : OK
Zip : 74104-4407
Country : US
Telephone Number : 918-633-8859
Fax Number :
Provider Business Practice Location Address
First Line : 2023 E 13TH PL
Second Line :
City : TULSA
State : OK
Zip : 74104-4407
Country : US
Telephone Number : 918-633-8859
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2015
Last Update Date : 01/20/2015

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Directions to “ MRS. JERRI DILLON RN” Practice Location

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