| NPI | 1568095412 |
|---|---|
| Former Name | PATRICIA LYNN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704199782) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MI 4704199782) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-02-19 |