| Jackie Latham, | |
|
3080 W 3rd St, Elk City, OK 73644-4323 | |
| (405) 424-7711 | |
| Not Available |
| Full Name | Jackie Latham |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 3080 W 3rd St, Elk City, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588345946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | L0056982 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Latham, Po Box 252, Carter, OK 73627-0252 Ph: () - | Jackie Latham, 3080 W 3rd St, Elk City, OK 73644-4323 Ph: (405) 424-7711 |
Robin Smith, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 3080 W 3rd St, Elk City, OK 73644 Phone: 405-424-7711 | |
Amy Battles, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 3080 W 3rd St, Elk City, OK 73644 Phone: 405-424-7711 |