Individual
MRS. ANGELA CHASE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
413 OWEN DRIVE, SUITE 201, FAYETTEVILLE, NC 28304-3411
(910) 323-9111
(910) 484-2535
Mailing address
413 OWEN DRIVE, SUITE 201, FAYETTEVILLE, NC 28304-3411
(910) 323-9111
(910) 484-2535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NC
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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