Individual
JOANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3300 MAIN ST, 2ND FLOOR, SUITE A, SPRINGFIELD, MA 01107-1112
(413) 794-2273
(413) 794-0198
Mailing address
280 CHESTNUT ST, 2ND FL, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
141500
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN141500
MA
363LF0000X
Family Nurse Practitioner
141500
MA
Other
Enumeration date
10/20/2006
Last updated
01/16/2019
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