Individual
POPPY CHRISTINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGPCNP-BC
Contact information
Practice address
325 W 15TH ST STE A, NEW YORK, NY 10011-5903
(212) 604-6059
Mailing address
325 W 15TH ST STE A, NEW YORK, NY 10011-5903
(212) 604-6059
(646) 537-9251
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310258
NY
Other
Enumeration date
08/11/2021
Last updated
10/23/2025
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