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Vivian Jackson
Student in an Organized Health Care Education/Training Program in Atoka, Oklahoma
NPI 1164804563

Vivian Jackson is a Student in an Organized Health Care Education/Training Program based in Atoka, OK. Vivian Jackson practices in Atoka, OK. The NPI Number for Vivian Jackson is 1164804563 and holds a License No. (Oklahoma).

The current practice location address for Vivian Jackson is 800 S Greathouse Dr, Atoka, OK and can be reached out via phone at 580-889-2424 and via fax at 580-889-4050.

Location: 800 S Greathouse Dr, Atoka, OK, 74525-0720
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164804563
Provider Name
Vivian Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
800 S Greathouse Dr, Atoka, OK, 74525-0720
Phone Number
580-889-2424
Fax Number
580-889-4050
Provider Enumeration Date
06/22/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
73-1311206 05 OK
institution
Provider Business Practice Location Address Details
Address
800 S Greathouse Dr
City
Atoka
State
Oklahoma
Zip
74525-3431
Phone Number
580-889-2424
Fax Number
580-889-4050
person
Provider Business Mailing Address Details
Address
800 S Greathouse Dr
City
Atoka
State
Oklahoma
Zip
74525-3431
Phone Number
580-889-2424
Fax Number
580-889-4050
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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