NPI 1821885229
Kealah Nicole Jackson
Practice location
- Address
- 4016 SE 48th St, Oklahoma City, OK 73135-2202
- Phone
- (405) 931-8552
- Mailing address
- 416 W 15th St STE 600, Edmond, OK 73013-3672
Registered specialties
Driver
Primary
Registry record
- NPI
- 1821885229
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 21 Apr 2025
- Record last updated
- 21 Apr 2025
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.