JAQUETTA JARAE ROBERSON (NPI# 1346882032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346882032 |
| Entity Type | Individual |
| Full Name | JAQUETTA JARAE ROBERSON |
| Practice Address |
1025 15th Ave Nw Ardmore OK 73401-1810 |
| Practice Telephone | 5803195305 |
| Mailing Telephone | 5803195305 |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
110221 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1025 15TH AVE NW |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932165768 | Frelyn G Loughridge | Nurse Practitioner | 1025 15th Ave Nw, Ardmore, OK 73401-1810 | 2006-04-21 |
| 1669716353 | Jeffrey David Munholland | Nurse Practitioner | 1025 15th Ave Nw, Ardmore, OK 73401-1810 | 2012-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962722769 | Jennifer Christopher | Nurse Practitioner | 26642 Main St, Ardmore, AL 35739-8273 | 2010-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700492618 | Jessica Kearney | Nurse Practitioner | 8116 Nw 161st Ter, Edmond, OK 73013-5510 | 2020-09-17 |
| 1346852191 | Oludari Olutokunbo Olajide | Nurse Practitioner | 10700 N Council Rd Apt 3, Oklahoma City, OK 73162-4366 | 2020-08-21 |
| 1124638192 | Amanda Rushing | Nurse Practitioner | 705 E Atlanta Ave, Davis, OK 73030-2982 | 2020-08-05 |
| 1104435999 | Julie Marie Kelly | Nurse Practitioner | 1615 S Eucalyptus Ave Ste 210, Broken Arrow, OK 74012-5993 | 2020-07-28 |
| 1750999413 | Staci Y Williams | Nurse Practitioner | 5606 Sw Lee Blvd Ste 203, Lawton, OK 73505-9651 | 2020-07-20 |
| 1063030088 | Kristal Ladawn Vasquez | Nurse Practitioner | 4019 North Flood Ave, Normam, OK 73069 | 2020-07-07 |
| 1144847542 | Premier Healthcare, Aprn-cnp | Nurse Practitioner | 12208 South Western Avenue, Suite B, Oklahoma City, OK 73170 | 2020-07-01 |
| 1578184560 | Heather Elaine Fry | Nurse Practitioner | 1908 E Gore Blvd Ste A, Lawton, OK 73501-6129 | 2020-04-30 |
| 1972137511 | Danielle Nicole Hurd | Nurse Practitioner | 1532 N Boston Pl, Tulsa, OK 74106-4104 | 2020-02-22 |
| 1427689215 | Bodyworx Primary Care, LLC | Nurse Practitioner | 4019 N Flood Ave, Norman, OK 73069 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.