NPI 1164804563

Vivian Jackson

Practitioner Student in an Organized Health Care Education/Training Program Atoka, OK

Practice location

Address: 800 S Greathouse Dr, Atoka, OK 74525-3431
Phone: (580) 889-2424
Fax: (580) 889-4050
Mailing address: PO Box 720, Atoka, OK 74525-0720

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Oklahoma →

Registry record

NPI: 1164804563
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Jun 2015
Record last updated: 22 Jun 2015

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.