Naomi Marie Jackson
Individual provider Active NPI Peer Specialist · Spencer, OK
NPI 1457034613 · NPPES record last updated Aug 14, 2023
Key facts
- NPI
- 1457034613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 8714 NE 47TH St
Spencer, OK 73084-2012 - Phone
- (405) 227-4604
- NPI assigned
- Aug 14, 2023
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
8714 NE 47TH St
Spencer, OK 73084-2012
Mailing address
8714 NE 47TH St
Spencer, OK 73084-2012
Phone (405) 227-4604
Other providers in Spencer, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2023. 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.