ALEXANDRIA NICHELLE JACKSON

GARY, IN
NPI1699277590
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN249768)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: GA  RN249768)
363LG0600X Nurse Practitioner, Gerontology
(Licence: GA  RN249768)
363LP2300X Nurse Practitioner, Primary Care
(Licence: GA  RN249768)
Enumeration Date2018-03-06
Last Update Date2024-10-02
Business Address
Ms. ALEXANDRIA NICHELLE JACKSON AGNP
215 BROADWAY
GARY, IN 46402-1221
Phone number: 219-888-5975
Mailing Address
Ms. ALEXANDRIA NICHELLE JACKSON AGNP
1701 E 69TH AVE
MERRILLVILLE, IN 46410-3903
Phone number: 229-291-4436