NPI 1477849826
Stacey Jo Jackson, BHRS
Practice location
- Address
- 17 S Central Ave, Idabel, OK 74745-4625
- Phone
- (580) 306-0303
- Mailing address
- Rr 3 Box 421, Broken Bow, OK 74728-9204
Registered specialties
Specialist
Primary
Registry record
- NPI
- 1477849826
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 23 Jun 2011
- Record last updated
- 23 Jun 2011
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.