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1558008789
LAWANDA BEVEL JACKSON
ST PETERSBURG, FL
NPI
1558008789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: FL 9365258)
Enumeration Date
2022-05-18
Last Update Date
2022-05-18
Business Address
LAWANDA BEVEL JACKSON APRN
1685 61ST AVE S
ST PETERSBURG, FL 33712-4920
Phone number: 727-290-8460
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Mailing Address
LAWANDA BEVEL JACKSON APRN
1685 61ST AVE S
ST PETERSBURG, FL 33712-4920
Phone number: 727-290-8460
Copy
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