Individual
JENNIFER SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-CNP
Contact information
Practice address
718 AVENUE A, BEAVER, OK 73932-3101
(580) 625-3477
Mailing address
PO BOX 1213, LAVERNE, OK 73848-1213
(580) 254-5322
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 0071514
OK
363LF0000X
Family Nurse Practitioner
Primary
205506
OK
Other
Enumeration date
01/27/2016
Last updated
09/19/2021
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