Individual
JAN LESLIE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
700 WALL ST, NORMAN, OK 73069
(405) 360-7337
(866) 259-0044
Mailing address
900 N PORTER AVE, SUITE 310, NORMAN, OK 73071-6424
(405) 579-1653
(405) 360-6315
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0040808
OK
Other
Enumeration date
11/21/2005
Last updated
11/08/2013
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