NICK JANSEN, PA-C, Medical ROTA, MP

Contact Information

NICK JANSEN, PA-C

SONGSONG VILLAGE
ROTA, MP 96951-1249

Phone: 670-532-9461
Fax: 670-532-0698
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Medical	363AM0700X	97	Physician Assistant
Student in an Organized Health Care Education/Training Program	390200000X

Indicates primary specialty

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NPI Profile & details for NICK JANSEN · (Male)

NPI Number	`1306193727`
Status	Active
Credentials	PA-C (Physician Assistant-Certified)
Entity	Individual
Enumeration date	08/06/2012
Last updated	10/23/2025 - About 7 months ago
Sole proprietor ¹	No
Identifiers	OK License # 2161
Hospital affiliation(s)	CREEK NATION COMMUNITY HOSPITAL - (Critical Access) 309 NORTH 14TH OKEMAH, OK 74859 OKMULGEE MEMORIAL HOSPITAL - (Acute Care) 1401 MORRIS DRIVE OKMULGEE, OK 74447

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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NICK JANSEN, PA-C – NPI #1306193727Medical

Contact Information

Specialty

Medical

Student in an Organized Health Care Education/Training Program

NPI Profile & details for NICK JANSEN · (Male)

Reviews for NICK JANSEN

NICK JANSEN, PA-C – NPI #1306193727
Medical