Individual
MS. PATRICIA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1252 N 22ND ST UNIT A, LARAMIE, WY 82072-5306
(307) 745-5364
(307) 745-4164
Mailing address
1252 N 22ND ST UNIT A, LARAMIE, WY 82072-5306
(307) 745-5364
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
43087
WY
363LF0000X
Family Nurse Practitioner
4708
CT
Other
Enumeration date
08/13/2006
Last updated
04/04/2019
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