Individual
MRS. TIMBER LAINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1391 COUNTY ROAD 1215, TUTTLE, OK 73089-3047
(405) 412-5862
Mailing address
1391 COUNTY ROAD 1215, TUTTLE, OK 73089-3047
(405) 412-5862
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
98752
OK
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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