| NPI | 1528581444 |
|---|---|
| Former Name | ERIN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: KY PA2281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2281) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2025-05-07 |