Individual
MRS. JENNIFER DAWN CHEATWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
RR 1,, BOLEY, OK 74829
(918) 667-3367
(918) 667-3387
Mailing address
PO BOX 218, BOLEY, OK 74829-0218
(918) 667-3367
(918) 667-3387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
102935
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685660A
—
OK
05
—
100685660D
—
OK
Enumeration date
08/16/2011
Last updated
08/16/2011
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