Individual
AMBER JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1100 N LINDSAY AVE, OKLAHOMA CITY, OK 73104-5410
(405) 271-4000
Mailing address
1100 N LINDSAY AVE, OKLAHOMA CITY, OK 73104-5410
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
24517356
OK
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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