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1033681655
T JACKSON
MONTEREY, CA
NPI
1033681655
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Former Name
TRACEY SOPER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95010717)
Enumeration Date
2018-12-20
Last Update Date
2024-08-02
Business Address
T JACKSON APRN
245 WASHINGTON ST
MONTEREY, CA 93940-2409
Phone number: 831-372-2273
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Mailing Address
T JACKSON APRN
713 MILTON BLUFF LANE
HOLLY SPRINGS, NC 27540-4503
Phone number: 984-332-7015
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