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Individual

MRS. JESSICA QUALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-C

Contact information

Practice address
14101 N EASTERN AVE STE B, EDMOND, OK 73013-5860
(405) 237-5698
(405) 513-6589
Mailing address
301 N WALKER AVE APT 8208, OKLAHOMA CITY, OK 73102-1872
(832) 655-4573

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
129429
OK

Other

Enumeration date
08/03/2018
Last updated
08/03/2018
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