Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2092 TIGER EYE CT, WINSTON-SALEM, NC 27127
(336) 986-6688
Mailing address
PO BOX 246, KERNERSVILLE, NC 27285-0246
(336) 986-6688
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
NC
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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