Individual
JACKLYN DAWN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
303 E TAFT AVE STE 3, SAPULPA, OK 74066-5651
(918) 224-2222
Mailing address
303 E TAFT AVE STE 3, SAPULPA, OK 74066-5651
(918) 224-2222
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
92995
OK
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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