Amber Nicole Jackson, L.P.N
Individual provider Active NPI Licensed Practical Nurse · Pawhuska, OK
NPI 1295941219 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295941219
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LOO51253 (OK)
- Practice address
- 1800 Claremore Ave
Pawhuska, OK 74056-1747 - Phone
- (918) 724-6435
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LOO51253 | OK | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LOO51253 | OK | Yes |
Addresses
Primary practice location
1800 Claremore Ave
Pawhuska, OK 74056-1747
Mailing address
1800 Claremore Ave
Pawhuska, OK 74056-1747
Phone (918) 724-6435
Other providers in Pawhuska, OK
- Elizabeth Rae Hovey
- Jerod Howard
- Amanda J Howerton
- Haley Hull
- Pamela Turner Hunt
- Cindy Kay Javellas
- Wenda Johnson
- Amy Suzanne Jones
- Rebecca Ann Jones
- Judith L Armstrong LLC
All providers in Pawhuska, OK · Licensed Practical Nurse in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.