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1508504515
DOMINIQUE JAQUETTA NICOLE BUCKNER
JACKSON, MS
NPI
1508504515
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MS 337392)
Enumeration Date
2022-05-20
Last Update Date
2023-03-20
Business Address
DOMINIQUE JAQUETTA NICOLE BUCKNER
655 MEADOWBROOK RD
JACKSON, MS 39206-5842
Phone number: 601-882-4878
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Mailing Address
DOMINIQUE JAQUETTA NICOLE BUCKNER
655 MEADOWBROOK RD
JACKSON, MS 39206-5842
Phone number: 601-882-4878
Copy
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