Provider Demographics
NPI:1437905767
Name:EVANS-PALMER, JOCELYN ELAINE (LPN)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:ELAINE
Last Name:EVANS-PALMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17405 S 323RD EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-3115
Mailing Address - Country:US
Mailing Address - Phone:918-486-3059
Mailing Address - Fax:
Practice Address - Street 1:17405 S 323RD EAST AVE
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-3115
Practice Address - Country:US
Practice Address - Phone:918-486-3059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0037095164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse