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1134662646
STEVIE JACKSON
BROOKHAVEN, MS
NPI
1134662646
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS 901629)
Enumeration Date
2016-12-01
Last Update Date
2017-03-17
Business Address
Mrs. STEVIE JACKSON NP-C
1007 W CONGRESS ST
BROOKHAVEN, MS 39601-2603
Phone number: 601-847-3712
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Mailing Address
Mrs. STEVIE JACKSON NP-C
1827 SIMPSON HIGHWAY 149
MENDENHALL, MS 39114-3439
Phone number: 601-894-6669
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