Individual
ASHLEY ROSE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
84 BROAD ST STE 3, GLENS FALLS, NY 12801-4381
(518) 798-9538
Mailing address
32 OLD POND RD, ROCHESTER, NY 14625-1540
(585) 230-2506
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383547-01
NY
Other
Enumeration date
07/07/2023
Last updated
08/23/2023
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