| NPI | 1710115167 |
|---|---|
| Former Name | JULIE E JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: GA RN170658) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2019-07-10 |