Provider Demographics
NPI:1538972880
Name:MCCALIP, JAIME LYNN
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LYNN
Last Name:MCCALIP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:LYNN
Other - Last Name:BARTSCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 S BULLITT ST
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-5217
Mailing Address - Country:US
Mailing Address - Phone:405-380-4602
Mailing Address - Fax:
Practice Address - Street 1:121 S BULLITT ST
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-5217
Practice Address - Country:US
Practice Address - Phone:405-380-4602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK221803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty