NPI | 1831385848 |
---|---|
Professional Name | NICOLE STEPHANIE JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN277697) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F334631 1) |
Enumeration Date | 2007-09-24 |
Last Update Date | 2022-03-23 |