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Individual

JILL JOLENE CARBAJAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
1503 HARBOR RD, GROVE, OK 74344-3525
(918) 786-3223
Mailing address
30351 S 650 RD, GROVE, OK 74344-7906
(918) 791-5413

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0127441
OK
363LF0000X
Family Nurse Practitioner
Primary
225593
OK

Other

Enumeration date
09/04/2025
Last updated
09/09/2025
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