| NPI | 1003917774 |
|---|---|
| Former Name | CHRISTINA LYNN DIX JACKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 72000043A) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: IN 72000043A) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IN 72000043A) | |
| 367A00000X Advanced Practice Midwife (Licence: IN 72000043A) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-03-03 |