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Contact Information

J K AT HOME
2237 W MEMORIAL RD STE 112
OKLAHOMA CITY, OK73134-8064
 Phone: 405-808-3714
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for J K AT HOME · (Female)

NPI # 1811607690
Status Active
Credentials
Entity Individual
Enumeration date 12/01/2022
Last updated 04/06/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK Medicaid 201149220A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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