Provider Demographics
NPI:1730072117
Name:EGNER, JAYD NICKOLE
Entity type:Individual
Prefix:MS
First Name:JAYD
Middle Name:NICKOLE
Last Name:EGNER
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 1:1349 KELLEY POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5897
Mailing Address - Country:US
Mailing Address - Phone:405-626-5343
Mailing Address - Fax:
Practice Address - Street 1:1100 N LINDSAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5410
Practice Address - Country:US
Practice Address - Phone:405-271-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program