Individual
KYLEE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4444 S HARVARD AVE STE 300, TULSA, OK 74135-2611
(918) 992-6400
Mailing address
PO BOX 1294, INOLA, OK 74036-1294
(918) 693-8393
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216736
OK
Other
Enumeration date
02/09/2024
Last updated
02/23/2024
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