Most Relevant Information
Provider Data
| NPI Number: | 1003279498 |
| Provider Name: | JARED QUALLS APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 102252 |
Most Important Dates
| Enumeration Date: | 04/01/2016 |
| Last Updated: | 06/21/2019 |
Provider Practice Location
1145 S UTICA AVE
SUITE 460
TULSA
OK
741044000
Practice Location Phone/Fax
| Phone: | 9185795749 |
| Fax: | 9185795762 |
Provider Mailing Location
1145 S UTICA AVE
SUITE 460
TULSA
OK
741044000
Provider Mailing Phone/Fax
| Phone: | 9185795749 |
| Fax: | 9185795762 |