MEDICARE: PRISCILLA E JONES COSMETOLOGIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	LURFUB3LIG	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225834104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA E JONES COSMETOLOGIST

Provider Business Mailing Address
First Line	:	800 NE 63RD ST STE 101C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73105-6422
Country	:	US
Telephone Number	:	405-413-2061
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 NE 63RD ST STE 101C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73105-6422
Country	:	US
Telephone Number	:	405-413-2061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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