Individual
JADE FINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 S 41ST ST E, MUSKOGEE, OK 74403-6253
(918) 718-6526
Mailing address
PO BOX 176, PEGGS, OK 74452-0176
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0068115
OK
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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