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1962441170
KIMETHRIA LAURIE JACKSON
ADA, OK
NPI
1962441170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OK R0046831)
Enumeration Date
2006-06-05
Last Update Date
2007-07-09
Business Address
-- KIMETHRIA LAURIE JACKSON MSN, ARNP
1201 ARLINGTON ST SUITE B
ADA, OK 74820-4072
Phone number: 580-436-1526
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Mailing Address
-- KIMETHRIA LAURIE JACKSON MSN, ARNP
1201 ARLINGTON ST SUITE B
ADA, OK 74820-4072
Phone number: 580-436-1526
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