Individual
JENNIFER LYNN JESTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 825-1405
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 825-1405
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
10/04/2021
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