| NPI | 1114565884 |
|---|---|
| Former Name | RACHEL KAYE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP144249) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP144249) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |