Organization
J K AT HOME
Active
Other names
HAPPY AT HOME
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN HERNDON (OWNER)
(405) 808-3714
Entity
Organization
Contact information
Practice address
2237 W MEMORIAL RD STE 112, OKLAHOMA CITY, OK 73134-8064
(405) 808-3714
Mailing address
2237 W MEMORIAL RD STE 112, OKLAHOMA CITY, OK 73134-8064
(405) 808-3714
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201149220A
—
OK
Enumeration date
12/01/2022
Last updated
04/06/2023
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