Healthcare Provider Details

I. General information

NPI: 1790872224
Provider Name (Legal Business Name): DEBORAH ANN JARRETT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHOCTAW WAY
TALIHINA OK
74571-2022
US

IV. Provider business mailing address

PO BOX 198 2050 GALLOWAY ROAD
NEWARK AR
72562-0198
US

V. Phone/Fax

Practice location:
  • Phone: 918-567-7000
  • Fax: 918-567-7113
Mailing address:
  • Phone: 870-799-2442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0076113
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: