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Individual
NORMA M JACKSON
Active
Individual
NORMA M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.007090
IL
363LF0000X
Family Nurse Practitioner
AP123742
TX
363LF0000X
Family Nurse Practitioner
SP008804
PA
Other
Enumeration date
08/07/2007
Last updated
03/09/2016
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