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Individual
MRS. AMY FAY JACKSON
Active
Individual
MRS. AMY FAY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1018934
TX
363LF0000X
Family Nurse Practitioner
1018934
TX
Other
Enumeration date
11/05/2020
Last updated
05/01/2023
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