LEA JACKSON

INDIANAPOLIS, IN
NPI1093282063
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  71012301A)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: WA  AP60914149)
363LF0000X Nurse Practitioner, Family
(Licence: WA  N360922794)
Enumeration Date2018-10-29
Last Update Date2023-10-06
Business Address
LEA JACKSON NP
1481 W 10TH ST
INDIANAPOLIS, IN 46202-2803
Phone number: 317-554-0000
Mailing Address
LEA JACKSON NP
1481 W 10TH ST
INDIANAPOLIS, IN 46202-2803
Phone number: