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1538586755
KELLEY R JACKSON
BUFFALO, NY
NPI
1538586755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 246502-1)
Enumeration Date
2014-03-26
Last Update Date
2014-03-26
Business Address
-- KELLEY R JACKSON LPN
32 ERICSON AVE
BUFFALO, NY 14215-3808
Phone number: 480-233-0850
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Mailing Address
-- KELLEY R JACKSON LPN
32 ERICSON AVE
BUFFALO, NY 14215-3808
Phone number: 480-233-0850
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