Individual
SONDRA P JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11439 E 5TH ST, TULSA, OK 74128-2015
(918) 978-2718
Mailing address
11439 E 5TH ST, TULSA, OK 74128-2015
(918) 978-2718
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
37V116698052
OK
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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