Individual
MALARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
609 W. MEMORIAL RD., OKLAHOMA CITY, OK 73114
(405) 418-5400
Mailing address
609 W. MEMORIAL RD, OKLAHOMA CITY, OK 73114
(405) 418-5400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
98159
OK
Other
Enumeration date
01/16/2014
Last updated
10/16/2015
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