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VIVIAN JACKSON
NPI 1164804563
Student in an Organized Health Care Education/Training Program in Atoka, OK

Active since June 22, 2015
800 S GREATHOUSE DR, ATOKA, OK 74525(580) 889-2424(580) 889-4050 Get Directions Write a Review

NPPES record last updated: June 22, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Vivian Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVIAN JACKSON (NPI 1164804563) is an individual student in an organized health care education/training program in Atoka, Oklahoma and active in the NPI registry since June 2015.

NPPES Registry Identity

NPI1164804563
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameVIVIAN JACKSON
Location Address800 S GREATHOUSE DRAtoka, OK 74525-3431
Mailing AddressPo Box 720Atoka, OK 74525-0720
Phone(580) 889-2424
Fax(580) 889-4050
Sole ProprietorYes
Enumeration DateJune 22, 2015
✔ NPI 1164804563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
800 S GREATHOUSE DR, Atoka, OK 74525
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Other Identifiers 1

Medicaid73-1311206OK

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISA HAMILTON
Student in an Organized Health Care Education/Training Program
800 S GREATHOUSE DR
ATOKA, OK 74525
Atoka County (580) 889-2424

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vivian Jackson's NPI number?

The NPI number for Vivian Jackson is 1164804563. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Where is Vivian Jackson located?

Vivian Jackson practices at 800 S Greathouse Dr, Atoka, OK 74525. The listed phone number is (580) 889-2424.

What is Vivian Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Vivian Jackson was last updated on June 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.