Healthcare Provider Details

I. General information

NPI: 1083493522
Provider Name (Legal Business Name): JESSICA LOAFMAN RN BHCMII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E MAIN ST
NORMAN OK
73071-5300
US

IV. Provider business mailing address

1120 E MAIN ST
NORMAN OK
73071-5300
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-3812
  • Fax:
Mailing address:
  • Phone: 918-991-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0122054
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number319647
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: