Healthcare Provider Details

I. General information

NPI: 1528559549
Provider Name (Legal Business Name): JESSICA CHRISTINE-DOSDON FRAZIER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA CHRISTINE DODSON

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 405-951-2545
  • Fax:
Mailing address:
  • Phone: 405-945-4587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number97991
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number97991
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number97991
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: