Jackson, Jacob

Jackson, Jacob is an individual health care provider with primary practice located at 1800 W 1St St Ste 105B , Elk City OK 73644-3133. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Medical-Surgical. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Jackson, Jacob can be contacted via phone (580) 225-2518.

Contact Information

Primary practice address
1800 W 1St St Ste 105B Elk City OK 73644-3133
Phone: (580) 225-2518
Fax: (580) 225-3167
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 113330 Oklahoma
Nursing Service Providers / Medical-Surgical 163WM0705X 113330 Oklahoma

Profile Details

NPI number 1134629405
LBN Legal business name Jackson, Jacob
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2018
Last updated Mar 26th, 2020 - 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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