Individual
MRS. DONNA G JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP MSN
Contact information
Practice address
4444 CORONA DR STE 137, CORPUS CHRISTI, TX 78411-4323
(361) 985-1221
(361) 985-1295
Mailing address
PO BOX 6696, CORPUS CHRISTI, TX 78466
(361) 985-1221
(361) 985-1295
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
537199
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141127401
—
TX
Enumeration date
02/07/2006
Last updated
07/14/2023
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