Individual
ALEKA JAQUAYA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 W 15TH ST, EDMOND, OK 73013-3621
(405) 858-1700
Mailing address
PO BOX 12978, OKLAHOMA CITY, OK 73157-2978
(405) 858-1737
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0058007
OK
Other
Enumeration date
02/07/2025
Last updated
07/07/2025
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