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1346204427
STEFANIE M JACKSON
LAKE CITY, FL
NPI
1346204427
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL ARNP 2620432)
Enumeration Date
2006-04-14
Last Update Date
2010-06-25
Business Address
-- STEFANIE M JACKSON ARNP
1289 SW STATE ROAD 47
LAKE CITY, FL 32025-0484
Phone number: 386-755-0421
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Mailing Address
-- STEFANIE M JACKSON ARNP
1289 SW STATE ROAD 47
LAKE CITY, FL 32025-0484
Phone number: 386-755-0421
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