Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Willson

Individual provider Nurse Practitioner · NPI 1215826037

Jonathan Willson is a Nurse Practitioner in Broken Arrow, Oklahoma. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Oklahoma.

Years since qualifying
1
Licensed in
OK
In the registry since
2025
Specialties on file
2

Practice location Address checks out

109 W Commercial St
Broken Arrow, OK 74012-4012
Phone: (918) 887-8300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 225851 (OK)
Registered Nurse Taxonomy 163W00000X · Licence R0133031 (OK)

Record details

NPI number1215826037
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 30, 2025
Last updated in NPPESDecember 18, 2025
Certification dateDecember 18, 2025
Mailing address109 W Commercial St, Broken Arrow, OK 74012-4012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Broken Arrow