(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003062423
Provider Name: JACKIE SUE TARR LPN
Entity Type: Individual
Taxonomy Code: 164W00000X
Specialty: Licensed Practical Nurse
License Number: L0018866
Most Important Dates
Enumeration Date: 08/18/2008
Last Updated: 08/18/2008
Provider Practice Location
1417 MCGRAW DR
PONCA CITY
OK
746012948
Practice Location Phone/Fax
Phone: 5807651926
Fax:
Provider Mailing Location
1417 MCGRAW DR
PONCA CITY
OK
746012948
Provider Mailing Phone/Fax
Phone: 5807651926
Fax: