| NPI | 1699810788 |
|---|---|
| Professional Name | TANYA DIANE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: TX 252294) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |