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1144437815
RUTH V JACKSON
SPRINGFIELD, IL
NPI
1144437815
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209-003223)
Enumeration Date
2007-05-16
Last Update Date
2011-02-15
Business Address
-- RUTH V JACKSON NNP
415 N 9TH ST 4W16
SPRINGFIELD, IL 62702-5303
Phone number: 800-331-2229
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Mailing Address
-- RUTH V JACKSON NNP
PO BOX 19676
SPRINGFIELD, IL 62794-9676
Phone number: 800-331-2229
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