Individual
DR. STEPHANIE COLLEEN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
275 10TH ST SE STE 3320, CEDAR RAPIDS, IA 52403-2450
(319) 398-1721
Mailing address
275 10TH ST SE STE 3320, CEDAR RAPIDS, IA 52403-2450
(319) 398-1721
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
1252071
IA
2084N0400X
Neurology Physician
Primary
14922
NV
2084N0400X
Neurology Physician
85523-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14922
MEDICAL LICENSE
NV
Enumeration date
06/13/2008
Last updated
03/28/2025
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