Individual
JACINDA HANTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
4400 GRANT BLVD, YUKON, OK 73099-0037
(405) 603-4660
(405) 470-3377
Mailing address
4400 GRANT BLVD, YUKON, OK 73099-0037
(405) 603-4660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
96351
OK
Other
Enumeration date
11/13/2016
Last updated
07/17/2020
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