CLARK JACKSON

LINCOLN, NE
NPI1053768945
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: NE  70693)
Enumeration Date2016-05-20
Last Update Date2016-05-20
Business Address
-- CLARK JACKSON
2500 S 60TH ST APT 21
LINCOLN, NE 68506-3579
Phone number: 402-613-2633
Mailing Address
-- CLARK JACKSON
2500 S 60TH ST APT 21
LINCOLN, NE 68506-3579
Phone number: 402-613-2633
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