CHANELL SHANNON JACKSON

CULVER CITY, CA
NPI1356011597
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy176B00000X Midwife
(Licence: CA  236061)
Additional Taxonomies363LW0102X Nurse Practitioner, Women's Health
(Licence: CA  236061)
Enumeration Date2021-09-19
Last Update Date2022-03-30
Business Address
CHANELL SHANNON JACKSON NMW, WHNP
5883 1/2 DOVERWOOD DR
CULVER CITY, CA 90230-7203
Phone number: 310-848-7736
Mailing Address
CHANELL SHANNON JACKSON NMW, WHNP
5883 1/2 DOVERWOOD DR
CULVER CITY, CA 90230-7203
Phone number: 310-848-7736
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