Individual
JESSICA LEIGH HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 N HIGHWAY 66, STE B, CATOOSA, OK 74015-3073
(918) 266-4433
(918) 266-4244
Mailing address
2400 N HIGHWAY 66, STE B, CATOOSA, OK 74015-3073
(918) 266-4433
(918) 266-4244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2083
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200427800A
—
OK
Enumeration date
02/03/2012
Last updated
05/01/2014
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