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Individual
VICTORIA LYNN JACKSON
Active
Individual
VICTORIA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, PA-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95025977
CA
163WC1500X
Community Health Registered Nurse
544793
CA
363A00000X
Physician Assistant
PA56381
CA
363L00000X
Nurse Practitioner
Primary
95010493
CA
Other
Enumeration date
11/08/2018
Last updated
09/26/2024
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