Kealah Nicole Jackson

NPI #1821885229 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1821885229
Entity Type: Individual
Name: Kealah Nicole Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Apr 21, 2025
Last Updated: Apr 21, 2025

Practice Location

Address: 4016 SE 48TH ST
City: Oklahoma City
State: Oklahoma
ZIP Code: 73135-2202
Phone: (405) 931-8552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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