| NPI | 1528499761 |
|---|---|
| Former Name | MADELINE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.15661-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9324604) |
| 163W00000X Registered Nurse (Licence: OH RN373859) | |
| 363L00000X Nurse Practitioner (Licence: FL APRN9324604) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2021-07-14 |