Individual
TIMOTHY JACKSON FLEETWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5091
(918) 342-6495
Mailing address
317 E WILL ROGERS BLVD, CLAREMORE, OK 74017-7454
(918) 906-7093
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
203762
OK
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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