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Contact Information

TONI D JACKSON, DNP, APRN, NP-C
915 E OWEN K GARRIOTT RD STE E
ENID, OK73701-6153
 Phone: 580-701-2582
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Critical Care Medicine

163WC0200X
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for TONI D JACKSON · (Female)

NPI Number 1508532045
Status Active
Credentials DNP, APRN, NP-C
Entity Individual
Enumeration date 08/16/2021
Last updated 10/23/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 205705
  • OK License # R0091913
Hospital affiliation(s)
  • FAIRVIEW REGIONAL MEDICAL CENTER - (Critical Access)
    523 EAST STATE ROAD
    FAIRVIEW, OK 73737
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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