ANCELLE JACKSON

BONAIRE, GA
NPI1477027373
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  RN300851)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: FL  11000926)
Enumeration Date2019-01-14
Last Update Date2021-06-18
Business Address
ANCELLE JACKSON APRN
774 HIGHWAY 96
BONAIRE, GA 31005-3300
Phone number: 478-988-5711
Mailing Address
ANCELLE JACKSON APRN
2620 ELM HILL PIKE
NASHVILLE, TN 37214-3108
Phone number: