Provider Demographics
NPI:1700626199
Name:MCWILLIAMS, JASHANA
Entity type:Individual
Prefix:
First Name:JASHANA
Middle Name:
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 S 77TH EAST AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3955
Mailing Address - Country:US
Mailing Address - Phone:918-814-2428
Mailing Address - Fax:
Practice Address - Street 1:8131 S 77TH EAST AVE APT 102
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3955
Practice Address - Country:US
Practice Address - Phone:918-814-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDOULAOtherDOULA