| NPI | 1497714794 |
|---|---|
| Former Name | BARBARA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN6961) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 99118) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-03-31 |