Individual
KATINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
206 E BLUE STARR DR, CLAREMORE, OK 74017-4223
(918) 341-8100
Mailing address
206 E BLUE STARR DR, CLAREMORE, OK 74017-4223
(918) 872-8822
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
215992
OK
Other
Enumeration date
02/05/2024
Last updated
08/06/2024
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