Individual
MRS. JILLIAN BETH FATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP, APRN
Contact information
Practice address
707 S OSAGE AVE, BARTLESVILLE, OK 74003-4943
(918) 876-0223
Mailing address
912 W FARGO ST, BROKEN ARROW, OK 74012-0829
(918) 694-1382
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
89462
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200436700A
—
OK
Enumeration date
03/21/2012
Last updated
11/10/2020
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