Healthcare Provider Details

I. General information

NPI: 1114813342
Provider Name (Legal Business Name): JESSICA NICOLE BINNS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25012 S 4420 RD
VINITA OK
74301-5272
US

IV. Provider business mailing address

25012 S 4420 RD
VINITA OK
74301-5272
US

V. Phone/Fax

Practice location:
  • Phone: 918-256-7841
  • Fax:
Mailing address:
  • Phone: 918-256-7841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number39204
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number229829
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: