Vicki Lyn Jackson
Individual provider Active NPI Case Manager/Care Coordinator · Shady Point, OK
NPI 1649622010 · NPPES record last updated Jul 8, 2016
Key facts
- NPI
- 1649622010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 26496 255TH Ave
Shady Point, OK 74956-2011 - Phone
- (918) 721-6515
- NPI assigned
- Jul 8, 2016
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
26496 255TH Ave
Shady Point, OK 74956-2011
Mailing address
26496 255TH Avenue
Shady Point, OK 74956
Phone (918) 721-6515
Other providers in Shady Point, OK
- Natalie Brittingham
- Cameo Home Care Inc.
- Maddison Elizabeth Colwell
- Barbara A. Dooty
- Jamy Graham
- Love Fostering Hope Inc
- Christopher Ragan
- Shady Point Schools
All providers in Shady Point, OK · Case Manager/Care Coordinator 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, 2016. 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.