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1598078404
BERTHA ADELE JACKSON
PHILADELPHIA, PA
NPI
1598078404
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: PA SP010712)
Enumeration Date
2010-07-20
Last Update Date
2010-07-20
Business Address
Ms. BERTHA ADELE JACKSON CRNP
5501 OLD YORK RD PALEY FIRST FLOOR
PHILADELPHIA, PA 19141-3018
Phone number: 215-456-6532
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Mailing Address
Ms. BERTHA ADELE JACKSON CRNP
5501 OLD YORK RD PALEY FIRST FLOOR
PHILADELPHIA, PA 19141-3018
Phone number: 215-456-6532
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