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General NPI Number Information
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NPI Number | 1609756139
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Entity Type | Individual
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Provider Name | JILL JOLENE CARBAJAL APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 1503 HARBOR RD
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City | GROVE
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State | OK
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Zip | 74344-3525
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Country | US
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Telephone | 918-786-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 QUAIL SPRINGS PKWY FL 5
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-2640
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Country | US
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Telephone | 918-787-1909
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Fax | 918-787-3866
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 225593
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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 | R0127441
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License Number State | OK
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