Healthcare Provider Details

I. General information

NPI: 1245037159
Provider Name (Legal Business Name): JESSICA CLARISE PERKINS APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE 10TH ST # 4B
OKLAHOMA CITY OK
73104-5418
US

IV. Provider business mailing address

800 NE 10TH ST
OKLAHOMA CITY OK
73104-5418
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4088
  • Fax: 405-271-4099
Mailing address:
  • Phone: 479-283-9742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WU0100X
TaxonomyUrology Registered Nurse
License Number221862
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number221862
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: