Individual
MRS. MICHELLE A WILLIAMS- JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1930 S BROAD ST, PHILADELPHIA, PA 19145-2328
(215) 339-4563
Mailing address
1117 HARRISON ST, PHILADELPHIA, PA 19124-2907
(215) 744-6048
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
574196
PA
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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