Individual
MRS. BRANDI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
TENNESSEE VALLEY PEDIATRICS, 234 KELLER PARK, TUSCUMBIA, AL 35674
(256) 381-6963
Mailing address
5551 COUNTY ROAD 63, KILLEN, AL 35645
(256) 710-7277
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-108915
AL
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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