Jackson, Corie L
Jackson, Corie L is an individual health care provider with primary practice located at 2225 N Union St , Ponca City OK 74601-1555. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Jackson, Corie L can be contacted via phone (918) 308-5515.Contact Information
Primary practice address
2225 N Union St
Ponca City OK 74601-1555
Phone: (918) 308-5515
Fax: (580) 215-5765
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | G083070519 | Oklahoma |
Profile Details
| NPI number | 1558953042 |
|---|---|
| LBN Legal business name | Jackson, Corie L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2021 |
| Last updated | Mar 9th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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