Provider Demographics
NPI:1487231015
Name:OLOGOLO, JANEFRANCES
Entity type:Individual
Prefix:
First Name:JANEFRANCES
Middle Name:
Last Name:OLOGOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 S 129TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-3205
Mailing Address - Country:US
Mailing Address - Phone:918-899-6470
Mailing Address - Fax:949-703-7767
Practice Address - Street 1:3171 S 129TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-3205
Practice Address - Country:US
Practice Address - Phone:918-899-6470
Practice Address - Fax:949-703-7767
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0100448363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner