Individual
MS. BRIANNE MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
425 W 5TH ST, EAST LIVERPOOL, OH 43920-2405
(330) 385-7200
Mailing address
14601 OLD FREDERICKTOWN RD, EAST LIVERPOOL, OH 43920-9526
(330) 385-8280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
404613
OH
163W00000X
Registered Nurse
664233
PA
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.021858
OH
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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