Basic Information
Provider Information
NPI: 1699327270
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HONEYWELL
FirstName: JACALYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 8024 ERRYN LN
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731357204
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1000 N LEE AVE
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731021036
CountryCode: US
TelephoneNumber: 4052727000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2019
LastUpdateDate: 07/30/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/30/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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