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Individual
MRS. KRISTEN JACKSON
Active
Individual
MRS. KRISTEN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
658192
NY
163WH0200X
Home Health Registered Nurse
658192
NY
163WN0002X
Neonatal Intensive Care Registered Nurse
658192
NY
163WN0003X
Low-Risk Neonatal Registered Nurse
658192
NY
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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