Individual
JESSICA NICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 779-7216
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0053513
OK
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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