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General NPI Number Information
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NPI Number | 1811588809
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Entity Type | Individual
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Provider Name | JENNIFER LYNN PURSELL LEMON M.ED.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 4450 BUFFALO HL
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City | GUTHRIE
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State | OK
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Zip | 73044-9511
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Country | US
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Telephone | 405-418-8522
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Fax | 405-418-8665
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Provider Business Mailing Address
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Address Line | 7510 BROADWAY EXT STE 205
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-9031
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Country | US
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Telephone | 405-418-8522
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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