Healthcare Provider Details

I. General information

NPI: 1609165281
Provider Name (Legal Business Name): KELLI J JONES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE STE 7F
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

3605 CASTLEROCK RD
NORMAN OK
73072-1737
US

V. Phone/Fax

Practice location:
  • Phone: 572-244-0041
  • Fax:
Mailing address:
  • Phone: 918-510-3577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN78832
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: