EMMA J JACKSON

LAKE ELSINORE, CA
NPI1255809372
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163WP0200X Registered Nurse, Pediatrics
(Licence: CA  95042368)
Additional Taxonomies163W00000X Registered Nurse
(Licence: CA  RN95042368)
363LF0000X Nurse Practitioner, Family
(Licence: CA  NP950147)
Enumeration Date2018-11-06
Last Update Date2020-08-07
Business Address
EMMA J JACKSON NP
33048 CANOPY LN
LAKE ELSINORE, CA 92532-2535
Phone number: 909-614-3039
Mailing Address
EMMA J JACKSON NP
33048 CANOPY LN
LAKE ELSINORE, CA 92532-2535
Phone number: 909-614-3039