Individual
KELLY ANN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1012 N MAIN ST, SIKESTON, MO 63801-5097
(573) 471-0330
(573) 471-0461
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021028633
MO
Other
Enumeration date
12/15/2021
Last updated
12/22/2021
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