Kameron R Jackson
Individual provider Active NPI Peer Specialist · Tecumseh, OK
NPI 1043944754 · NPPES record last updated Jul 11, 2022
Key facts
- NPI
- 1043944754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 24962 Okay Rd
Tecumseh, OK 74873-6504 - Phone
- (817) 372-5098
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
24962 Okay Rd
Tecumseh, OK 74873-6504
Mailing address
1300 Crown Point Ave Apt 21
Norman, OK 73072-5866
Phone (817) 372-5098
Other providers in Tecumseh, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.