Individual
JEANA BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-FNP
Contact information
Practice address
2017 W I 35 FRONTAGE RD STE 170, EDMOND, OK 73013-8558
(405) 757-3365
Mailing address
2017 W I 35 FRONTAGE RD STE 170, EDMOND, OK 73013-8558
(405) 757-3365
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
83545
OK
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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