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1780412783
RONICA JACKSON
FORT WAYNE, IN
NPI
1780412783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IN 28208894A)
Enumeration Date
2024-07-23
Last Update Date
2024-07-23
Business Address
RONICA JACKSON PMHNP
3512 STELLHORN RD
FORT WAYNE, IN 46815-4631
Phone number: 260-483-9081
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Mailing Address
RONICA JACKSON PMHNP
PO BOX 392552
PITTSBURGH, PA 15251-9500
Phone number: 512-792-4402
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