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1467221770
LYNETTE JACKSON
PHILADELPHIA, PA
NPI
1467221770
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: PA PN106995L)
Enumeration Date
2023-12-28
Last Update Date
2023-12-28
Business Address
LYNETTE JACKSON
5000 PARKSIDE AVE
PHILADELPHIA, PA 19131-4714
Phone number: 215-879-6116
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Mailing Address
LYNETTE JACKSON
6139 NASSAU RD
PHILADELPHIA, PA 19151-4506
Phone number: 267-973-1679
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