DOMINIQUE TERENCE JACKSON

COLUMBUS, OH
NPI1174081822
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: OH  APRN.CNP.024669)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-03-12
Last Update Date2019-08-06
Business Address
DOMINIQUE TERENCE JACKSON Nurse Practitioner
1791 ALUM CREEK DR STE 100
COLUMBUS, OH 43207
Phone number: 614-526-5420
Mailing Address
DOMINIQUE TERENCE JACKSON Nurse Practitioner
2780 AIRPORT DR STE 100
COLUMBUS, OH 43219-2289
Phone number: 614-859-1906