Individual
JESSICA NELL HOWARD MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
61 MOCCASIN LN, SPAVINAW, OK 74366-6603
(918) 399-1361
(918) 399-1361
Mailing address
61 MOCCASIN LN, SPAVINAW, OK 74366-6603
(918) 399-1361
(918) 399-1361
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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