Individual
NANCY LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
(918) 687-0976
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
(918) 687-0976
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
R29624
OK
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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