Provider Demographics
NPI:1093427817
Name:COLLETT, JESSICA MICHELE (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MICHELE
Last Name:COLLETT
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:123 ALAMOSA RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3126
Mailing Address - Country:US
Mailing Address - Phone:405-301-5802
Mailing Address - Fax:810-202-7375
Practice Address - Street 1:2457 WILCOX DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3956
Practice Address - Country:US
Practice Address - Phone:405-497-7395
Practice Address - Fax:810-202-7375
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2025-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK208107363LF0000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty