Individual
JESSICA RENEE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4221 S WESTERN AVE STE 5050, OKLAHOMA CITY, OK 73109-3499
(405) 636-7900
(405) 644-5168
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 636-7900
(405) 644-5168
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2454
OK
Other
Enumeration date
01/15/2015
Last updated
10/30/2020
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