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1952859175
DEANNA JACKSON
FORT PAYNE, AL
NPI
1952859175
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1090205)
Enumeration Date
2016-09-16
Last Update Date
2016-09-16
Business Address
-- DEANNA JACKSON
2615 GAULT AVE N
FORT PAYNE, AL 35967-3728
Phone number: 256-845-4134
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Mailing Address
-- DEANNA JACKSON
2615 GAULT AVE N
FORT PAYNE, AL 35967-3728
Phone number: 256-845-4134
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