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1558044644
KELLEY J JACKSON
PLACERVILLE, CA
NPI
1558044644
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LW0102X Nurse Practitioner, Women's Health
(Licence: CA 95026533)
Enumeration Date
2023-08-08
Last Update Date
2023-08-08
Business Address
KELLEY J JACKSON WHNP
1095 MARSHALL WAY
PLACERVILLE, CA 95667-5722
Phone number: 530-344-5470
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Mailing Address
KELLEY J JACKSON WHNP
1550 IRON POINT RD APT 1312
FOLSOM, CA 95630-7814
Phone number: 916-202-8490
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