Individual
MS. JODI LYNN JEAKINS-KOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
634 EDDY AVE, MISSOULA, MT 59812-1851
(406) 243-4330
Mailing address
9575 KEEGAN TRL, MISSOULA, MT 59808-9382
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
16154
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16154
RN ID NUMBER
MT
Enumeration date
04/17/2007
Last updated
07/08/2007
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