RUTH V JACKSON

SPRINGFIELD, IL
NPI1144437815
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209-003223)
Enumeration Date2007-05-16
Last Update Date2011-02-15
Business Address
-- RUTH V JACKSON NNP
415 N 9TH ST 4W16
SPRINGFIELD, IL 62702-5303
Phone number: 800-331-2229
Mailing Address
-- RUTH V JACKSON NNP
PO BOX 19676
SPRINGFIELD, IL 62794-9676
Phone number: 800-331-2229
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