Jacqueline Eloise Evans | Tulsa, OK • PECOS Search

Jacqueline Eloise Evans

Social Worker

Behavioral Health & Social Service Providers

6216 S Lewis Ave, Tulsa, OK 74136-1044

(918) 960-7852 (918) 812-4953

PECOS Enrollment

Based on the most recent information from CMS, provider Jacqueline Eloise Evans does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1861161176
Provider Type
Individual
Full Name
Evans, Jacqueline Eloise
Credential
MSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/9/2021
Last Updated
9/9/2021

Contact Information

Practice Location

6216 S Lewis Ave, Tulsa, OK 74136-1044

Unlisted Fax

Mailing Location

4916 S Pittsburg Ave, Tulsa, OK 74135-3110

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 8073-P Oklahoma