Individual provider · Type 1 NPI
Jacob Jackson, APRN, CNP
Family Nurse Practitioner · Elk City, OK
NPI number
1134629405
Active
Practice location
1800 W 1st St Ste 105B
Elk City, OK 73644-3133
Fax (580) 225-3167
Mailing address
PO Box 2339
Elk City, OK 73648-2339
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 113330 (OK) |
| Medical-Surgical Registered Nurse | 163WM0705X | 113330 (OK) |
Family Nurse Practitioner: Definition to come...
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About NPI 1134629405
Jacob Jackson, APRN, CNP's National Provider Identifier is 1134629405, issued on Feb 13, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Elk City, OK. The record was last updated on Mar 26, 2020.