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1215373980
MINYELLE JACKSON
BRENTWOOD, NY
NPI
1215373980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 287782)
Enumeration Date
2013-05-21
Last Update Date
2013-12-02
Business Address
-- MINYELLE JACKSON LPN
801 CROOKED HILL RD # 325
BRENTWOOD, NY 11717-1045
Phone number: 631-671-5798
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Mailing Address
-- MINYELLE JACKSON LPN
801 CROOKED HILL RD # 325
BRENTWOOD, NY 11717-1045
Phone number: 631-671-5798
Copy
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