| NPI | 1811381346 |
|---|---|
| Former Name | CYNTHIA ELLEN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MO 071569) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |