Provider Demographics
NPI:1124532890
Name:KITCHENS, JAMIE LARIE (DNP, APRN, CNP)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LARIE
Last Name:KITCHENS
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1145 S UTICA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4013
Mailing Address - Country:US
Mailing Address - Phone:918-579-3825
Mailing Address - Fax:918-403-6315
Practice Address - Street 1:2617 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7850
Practice Address - Country:US
Practice Address - Phone:918-455-4541
Practice Address - Fax:918-455-0414
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK54344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily