Individual
ALLIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1435 E BRADFORD PKWY STE 105, SPRINGFIELD, MO 65804-6512
(417) 881-4994
Mailing address
1435 E BRADFORD PKWY STE 105, SPRINGFIELD, MO 65804-6512
(417) 881-4994
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06211962
MO
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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