Provider Demographics
NPI:1124856281
Name:LLOYD, JENNY DAWN (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:DAWN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9170 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-1214
Mailing Address - Country:US
Mailing Address - Phone:918-382-8043
Mailing Address - Fax:
Practice Address - Street 1:1305 E TAFT AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-6033
Practice Address - Country:US
Practice Address - Phone:918-224-8425
Practice Address - Fax:918-224-8426
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219243363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily