NPI 1003509175

Raynisha Jackson

Practitioner Case Management Agency Tulsa, OK

Practice location

Address: 4907 S 73rd East Ave Unit 4, Tulsa, OK 74145-6741
Phone: (305) 713-2623

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

Other Case Management providers in Oklahoma →

Registry record

NPI: 1003509175
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Jun 2023
Record last updated: 2 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.