Organization
EAGLES NEST PEDIATRIC THERAPY
Active
Organization
EAGLES NEST PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L FITZPATRICK OTR/L (OWNER)
(405) 623-9178
Entity
Organization
Contact information
Practice address
14700 SHARON SPRINGS DR, JONES, OK 73049-8700
(405) 623-9178
Mailing address
14700 SHARON SPRINGS DR, JONES, OK 73049-8700
(405) 623-9178
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538279229
INDIVIDUAL NPI
OK
01
—
1593
OKLAHOMA MEDICAL LICENSURE BOARD
OK
Enumeration date
04/26/2022
Last updated
07/08/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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