Provider Demographics
NPI:1598649352
Name:RICHEY, JORDYN KAYLEE
Entity type:Individual
Prefix:DR
First Name:JORDYN
Middle Name:KAYLEE
Last Name:RICHEY
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:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:THOMAS
Mailing Address - State:OK
Mailing Address - Zip Code:73669-0347
Mailing Address - Country:US
Mailing Address - Phone:580-661-3545
Mailing Address - Fax:580-661-3540
Practice Address - Street 1:103 N OKLAHOMA ST
Practice Address - Street 2:
Practice Address - City:THOMAS
Practice Address - State:OK
Practice Address - Zip Code:73669-8266
Practice Address - Country:US
Practice Address - Phone:580-661-3545
Practice Address - Fax:580-661-3545
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist