Individual
JASON BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-4100
Mailing address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
81605
OK
Other
Enumeration date
06/05/2020
Last updated
02/01/2024
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