Individual
JAQUITA Y GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10901 E 48TH ST, TULSA, OK 74146-5830
(918) 749-8765
(918) 392-2155
Mailing address
10901 E 48TH ST, TULSA, OK 74146-5830
(918) 749-8765
(918) 392-2155
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
R0080870
OK
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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