Jackie Ray Wilson

Peer Specialist · Stroud, OK

Individual Active NPI

NPI number 1831835107

Practice location

119 W 2ND St
Stroud, OK 74079-4011
Phone
(405) 328-1549

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NPI record

NPI
1831835107
Entity type
Individual (Type 1)
Enumeration date
May 10, 2022
Last updated
December 16, 2022
Certified
December 16, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Peer Specialist Primary 175T00000X — —

Mailing address

6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone
(918) 664-4224

About Jackie Wilson

Jackie Ray Wilson is a healthcare provider registered in the NPI registry with the primary taxonomy Peer Specialist (code 175T00000X). The practice location is 119 W 2ND St, Stroud, OK 74079-4011. The NPI number 1831835107 was assigned on May 10, 2022 and the record was last updated on December 16, 2022.

Frequently asked questions

What is the NPI number of Jackie Ray Wilson?

The NPI number is 1831835107.

What is the phone number of Jackie Wilson?

The phone number listed for the practice location is (405) 328-1549.

Where is Jackie Wilson located?

119 W 2ND St, Stroud, OK 74079-4011.

What is the taxonomy code for Jackie Wilson?

The primary taxonomy code is 175T00000X – Peer Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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