| NPI | 1891070629 |
|---|---|
| Former Name | CHARMAINE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16156) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: TN 16156) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2019-02-05 |