Individual
LORA A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4185 E WILDCAT RESERVE PKWY, STE 100, HIGHLANDS RANCH, CO 80126-6801
(303) 791-7896
(303) 791-8152
Mailing address
4185 E WILDCAT RESERVE PKWY, STE 100, HIGHLANDS RANCH, CO 80126-6801
(303) 791-7896
(303) 791-8152
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
78444
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78444
NURSE LICENSE
CO
Enumeration date
01/25/2007
Last updated
07/08/2007
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