Individual
MRS. DORIAN D'SHAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APN-C
Contact information
Practice address
1010 HADDONFIELD BERLIN RD STE 400, VOORHEES, NJ 08043-3514
(856) 435-7007
(856) 435-4372
Mailing address
301 LIPPINCOTT DRIVE SUITE 410, NEW YORK, NY 10087-0001
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO12442500
NJ
363LW0102X
Women's Health Nurse Practitioner
Primary
26NJ00070500
NJ
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
26NJ00070500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226254
—
NJ
Enumeration date
12/05/2007
Last updated
09/25/2024
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