SAMALA JACKSON

PHILADELPHIA, PA
NPI1184362600
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: PA  Sp018935)
Enumeration Date2022-05-24
Last Update Date2022-05-24
Business Address
Ms. SAMALA JACKSON Crnp
9200 BUSTLETON AVE APT 1705
PHILADELPHIA, PA 19115-4230
Phone number: 215-760-6386
Mailing Address
Ms. SAMALA JACKSON Crnp
9200 BUSTLETON AVE APT 1705
PHILADELPHIA, PA 19115-4230
Phone number:
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