Individual
MRS. JESSICA FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3099
(580) 354-5400
(580) 354-5409
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3099
(580) 354-5400
(580) 354-5409
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
106355
OK
Other
Enumeration date
09/23/2015
Last updated
04/27/2018
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