Individual
MRS. KRISTIE LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3700 SOUTH MAIN STREET, BLACKSBURG, VA 24060
(540) 953-5385
Mailing address
2900 MUDPIKE ROAD, CHRISTIANSBURG, VA 24073
(540) 382-9139
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024167104
VA
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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