Individual
MRS. JAHARI MIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1816 S GARDENIA AVE, BROKEN ARROW, OK 74012
(918) 978-2853
Mailing address
1816 S GARDENIA AVE, BROKEN ARROW, OK 74012-9024
(918) 978-2853
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
216629
OK
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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