Individual
AMELIA DEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5221
(479) 787-9692
Mailing address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5221
(479) 787-9692
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A004287
AR
Other
Enumeration date
01/30/2015
Last updated
10/13/2023
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