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Individual
LATRINA COLLEEN JACKSON
Active
Individual
LATRINA COLLEEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
210120
NC
163WH0200X
Home Health Registered Nurse
Primary
210120
NC
163WI0500X
Infusion Therapy Registered Nurse
210120
NC
163WP0808X
Psychiatric/Mental Health Registered Nurse
210120
NC
Other
Enumeration date
12/05/2017
Last updated
03/17/2018
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