Provider Demographics
NPI:1518792118
Name:ESSARY, JERI (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:
Last Name:ESSARY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-5973
Mailing Address - Country:US
Mailing Address - Phone:405-664-6497
Mailing Address - Fax:
Practice Address - Street 1:1491 S SUNNYLANE RD
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3037
Practice Address - Country:US
Practice Address - Phone:405-437-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK220014363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health