Healthcare Provider Details

I. General information

NPI: 1790560183
Provider Name (Legal Business Name): OLIVIA JOY PARSONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 SE 29TH ST
DEL CITY OK
73115-4702
US

IV. Provider business mailing address

5300 SE 29TH ST
DEL CITY OK
73115-4702
US

V. Phone/Fax

Practice location:
  • Phone: 405-835-2770
  • Fax: 405-835-2766
Mailing address:
  • Phone: 405-835-2770
  • Fax: 405-835-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5802
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: