Individual
MEREDITH P JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3100 SW 89TH ST, OKLAHOMA CITY, OK 73159-7900
(405) 951-2815
Mailing address
PO BOX 840848, DALLAS, TX 75284-0848
(972) 283-1999
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
120702
OK
Other
Enumeration date
12/14/2018
Last updated
12/14/2018
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