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General NPI Number Information
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NPI Number | 1275906455
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Entity Type | Individual
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Provider Name | JESSICA KEASTER APRN,CNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 3300 NW EXPRESSWAY
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4418
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Country | US
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Telephone | 405-949-3349
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 N INDEPENDENCE AVE STE 280
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-5555
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 102341
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R087203
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 102341
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License Number State | OK
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