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Individual

LEAH JACKSON

Active
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Individual

LEAH JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00155803
WA
363LA2100X
Acute Care Nurse Practitioner
AP61051873
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
72172
ID
363LG0600X
Gerontology Nurse Practitioner
AP61051873
WA

Other

Enumeration date
11/09/2017
Last updated
10/13/2023
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