Individual
KIMBERLY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2304 W HEFNER RD # 20904, OKLAHOMA CITY, OK 73120-9998
(405) 708-8773
Mailing address
2304 W HEFNER RD # 20904, OKLAHOMA CITY, OK 73120-9998
(405) 708-8773
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
321622
OK
Other
Enumeration date
02/16/2024
Last updated
11/04/2025
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