Individual
MS. ARLENE JAQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 964-5770
(405) 964-5788
Mailing address
1032 SW 61ST ST, OKLAHOMA CITY, OK 73139-1208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L64016
OK
Other
Enumeration date
07/14/2014
Last updated
07/17/2014
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