| NPI | 1619226834 | 
|---|---|
| Former Name | MARJAY G JACKSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN178428)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN178428)  | 
| Enumeration Date | 2012-09-04 | 
| Last Update Date | 2023-02-08 |