| NPI | 1760927040 |
|---|---|
| Former Name | SAMANTHA GERMAINE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP132837) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP132837) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2022-05-06 |