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1457993750
FREDERICKA JACKSON
LA VISTA, NE
NPI
1457993750
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NE 112991)
Enumeration Date
2019-10-08
Last Update Date
2020-07-02
Business Address
FREDERICKA JACKSON
6901 S 84TH ST
LA VISTA, NE 68128-2127
Phone number: 402-339-1090
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Mailing Address
FREDERICKA JACKSON
6901 S 84TH ST
LA VISTA, NE 68128-2127
Phone number: 402-339-1090
Copy
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