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Jackie Dalizu Mwendwa, CNP
Family Nurse Practitioner in Broken Arrow, Oklahoma
NPI 1134896236

Jackie Dalizu Mwendwa is a Family Nurse Practitioner based in Broken Arrow, OK and is specialized in Family. Jackie Dalizu Mwendwa practices in Broken Arrow, OK and has the professional credentials of CNP. The NPI Number for Jackie Dalizu Mwendwa is 1134896236 and holds a License No. 205174 (Oklahoma).

The current practice location address for Jackie Dalizu Mwendwa is 1800 W Albany Dr Apt 2026, Broken Arrow, OK and can be reached out via phone at 918-378-7825.

Location: 1800 W Albany Dr Apt 2026, Broken Arrow, OK, 74012-5853
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134896236
Provider Name
Jackie Dalizu Mwendwa
Credential
CNP
Provider Entity Type
Individual
Gender
Female
Address
1800 W Albany Dr Apt 2026, Broken Arrow, OK, 74012-5853
Phone Number
918-378-7825
Fax Number
Provider Enumeration Date
08/26/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1800 W Albany Dr Apt 2026
City
Broken Arrow
State
Oklahoma
Zip
74012-5853
Phone Number
918-378-7825
Fax Number
person
Provider Business Mailing Address Details
Address
1800 W Albany Dr Apt 2026
City
Broken Arrow
State
Oklahoma
Zip
74012-5853
Phone Number
918-378-7825
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
205174 (Oklahoma)
Definition
Definition to come...
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