Provider Demographics
NPI:1619799160
Name:ATKINS, JORDYNN (LPN)
Entity type:Individual
Prefix:
First Name:JORDYNN
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 60 BOX 153
Mailing Address - Street 2:
Mailing Address - City:WELTY
Mailing Address - State:OK
Mailing Address - Zip Code:74833-9001
Mailing Address - Country:US
Mailing Address - Phone:918-716-8772
Mailing Address - Fax:
Practice Address - Street 1:HC 60 BOX 153
Practice Address - Street 2:
Practice Address - City:WELTY
Practice Address - State:OK
Practice Address - Zip Code:74833-9001
Practice Address - Country:US
Practice Address - Phone:918-716-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210013164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse