MEDICARE: KELLI J JONES APRN

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	363LP0200X	Pediatric Nurse Practitioner	APN78832	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	:	1609165281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI J JONES APRN

Provider Business Mailing Address
First Line	:	3605 CASTLEROCK RD
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-1737
Country	:	US
Telephone Number	:	918-510-3577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 MAGNOLIA CT STE 101
Second Line	:
City	:	MOORE
State	:	OK
Zip	:	73160-1433
Country	:	US
Telephone Number	:	405-857-7681
Fax Number	:

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

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	03/26/2025

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