Individual
VANESSA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 W SCENIC DR APT 136, NORTH LITTLE ROCK, AR 72118-2271
(501) 952-5784
Mailing address
700 W SCENIC DR APT 136, NORTH LITTLE ROCK, AR 72118-2271
(501) 952-5784
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
926578477
AR
Other
Enumeration date
07/13/2023
Last updated
08/08/2023
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