Provider Demographics
NPI:1225834104
Name:JONES, PRISCILLA E (COSMETOLOGIST)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:E
Last Name:JONES
Suffix:
Gender:
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NE 63RD ST STE 101C
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-6422
Mailing Address - Country:US
Mailing Address - Phone:405-413-2061
Mailing Address - Fax:
Practice Address - Street 1:800 NE 63RD ST STE 101C
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-6422
Practice Address - Country:US
Practice Address - Phone:405-413-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLURFUB3LIG174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK335E00000XMedicaid