Individual
JAYNE ANN BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 W 1ST ST STE 102, ELK CITY, OK 73644-3133
(580) 225-2515
(580) 303-5850
Mailing address
1710 W 3RD ST STE 100, ELK CITY, OK 73644-5160
(580) 339-8001
(580) 339-8031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
88982
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511070A
—
OK
Enumeration date
07/07/2013
Last updated
03/10/2025
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