Individual
MRS. JACKIE DEE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-1900
(918) 494-6303
Mailing address
11150 HWY 49, GULFPORT, MS 39503-3347
(228) 831-1700
(918) 488-6010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
111885
OK
363LF0000X
Family Nurse Practitioner
Primary
813602
MS
Other
Enumeration date
11/14/2010
Last updated
01/09/2024
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