Healthcare Provider Details

I. General information

NPI: 1679273130
Provider Name (Legal Business Name): JULIA ELIZABETH JONES CNP-FAMILY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 S MUSKOGEE AVE STE C
TAHLEQUAH OK
74464-5440
US

IV. Provider business mailing address

4261 N 495 RD
ROSE OK
74364-2194
US

V. Phone/Fax

Practice location:
  • Phone: 918-772-5456
  • Fax: 918-223-8400
Mailing address:
  • Phone: 830-515-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number210785
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: