| NPI | 1760255681 |
|---|---|
| Former Name | MCKINLEY SUZANNE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 34655) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TN 233323) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |