Timber Laine Jackson, FNP-C Valid NPI

Individual provider · Family Nurse Practitioner · Tuttle, OK

NPI

1164021150

Type

Individual (Type 1)

Primary specialty

Family Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LF0000X

License number

98752 (OK)

Sex

Female

Sole proprietor

No

Enumerated

2020-10-20

Last updated

2020-10-20