Individual
MS. CAROL BOWSER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9501 FARRELL RD, BLDG 815,RM 139, FORT BELVOIR, VA 22060-5901
(703) 805-0498
Mailing address
5805 TERENCE DR, CLINTON, MD 20735-3742
(301) 856-5259
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
R103314
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R103314
NURSING
MD
Enumeration date
11/09/2006
Last updated
07/08/2007
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