Individual
LETITIA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
2000 W GRANT AVE STE 2, PAULS VALLEY, OK 73075-9234
(405) 238-3900
(405) 238-3903
Mailing address
2000 W GRANT AVE STE 2, PAULS VALLEY, OK 73075-9234
(405) 238-3900
(580) 238-3903
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
67505
OK
Other
Enumeration date
09/02/2014
Last updated
01/15/2024
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