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Organization
SENIOR HEALTH SOURCE LLC
Active
Organization
SENIOR HEALTH SOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN L JACKSON CRNP (OWNER)
(251) 533-6372
Entity
Organization
Contact information
Practice address
27440 COUNTY ROAD 13, DAPHNE, AL 36526-6222
(251) 533-6372
Mailing address
PO BOX 7872, SPANISH FORT, AL 36577-7872
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
1-087343
AL
Other
Enumeration date
06/21/2011
Last updated
12/30/2011
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