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 Date2024-09-19
Business Address
Ms. SAMALA JACKSON Crnp
3621 ARAMINGO AVE STE 5C
PHILADELPHIA, PA 19134-4607
Phone number: 215-444-7472
Mailing Address
Ms. SAMALA JACKSON Crnp
PO BOX 746722
ATLANTA, GA 30374-6722
Phone number: 773-352-1515
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