Provider Demographics
NPI:1386169555
Name:JONES, KASI CHE'DON (CNP)
Entity type:Individual
Prefix:
First Name:KASI
Middle Name:CHE'DON
Last Name:JONES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KASI
Other - Middle Name:CHE'DON
Other - Last Name:WHATLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1034 HANOVER RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:OK
Mailing Address - Zip Code:73030-9545
Mailing Address - Country:US
Mailing Address - Phone:580-247-5936
Mailing Address - Fax:
Practice Address - Street 1:1034 HANOVER RD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:OK
Practice Address - Zip Code:73030-9545
Practice Address - Country:US
Practice Address - Phone:580-247-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK108875363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK108875OtherOKLAHOMA STATE BOARD OF NURSING