Healthcare Provider Details

I. General information

NPI: 1528976008
Provider Name (Legal Business Name): DAVELL LANORA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7454 E 2ND ST
TULSA OK
74112-2106
US

IV. Provider business mailing address

7454 E 2ND ST
TULSA OK
74112-2106
US

V. Phone/Fax

Practice location:
  • Phone: 918-402-6568
  • Fax:
Mailing address:
  • Phone: 918-402-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0096779
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: