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Individual

MRS. TONI DAWN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, APRN, NP-C

Contact information

Practice address
915 E OWEN K GARRIOTT RD STE E, ENID, OK 73701-6153
(580) 701-2582
Mailing address
1302 S 30TH ST, ENID, OK 73701-7658
(580) 278-9425

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R0091913
OK
207Q00000X
Family Medicine Physician
205705
OK
363LF0000X
Family Nurse Practitioner
Primary
205705
OK

Other

Enumeration date
08/16/2021
Last updated
10/23/2024
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