Individual
JACKIE CHAVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 N GRAND ST, ENID, OK 73701-3221
(580) 234-3791
(580) 237-7711
Mailing address
1222 10TH ST STE 211, WOODWARD, OK 73801-3156
(580) 234-3791
(580) 237-7711
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R0062614
OK
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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