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Individual

JAZMINE GOINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3015 E SKELLY DR, SUITE 103, TULSA, OK 74105-6317
(918) 712-0859
(918) 388-6456
Mailing address
3015 E SKELLY DR, SUITE 103, TULSA, OK 74105-6317
(918) 712-0859
(918) 388-6456

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0053794
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100746170G
OK
05
100746170W
OK
Enumeration date
03/18/2015
Last updated
03/18/2015
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