| NPI | 1801427448 |
|---|---|
| Former Name | CALICE DANAE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014247) |
| Additional Taxonomies | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: CA 837226) |
| Enumeration Date | 2020-02-02 |
| Last Update Date | 2020-03-19 |