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Individual

JACOB JOEL PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(844) 458-2100
Mailing address
1100 S MADISON BLVD APT 306, BARTLESVILLE, OK 74006-7921
(918) 261-9613

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
OK
3747P1801X
Personal Care Attendant
37V103297101
OK
376K00000X
Nurse's Aide
Primary
37V735271116
OK

Other

Enumeration date
11/04/2025
Last updated
11/04/2025
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