Individual
DANIELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8645 CONNECTICUT ST, MERRILLVILLE, IN 46410-6222
(219) 769-3500
Mailing address
18132 SAN DIEGO AVE, HOMEWOOD, IL 60430-1522
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015748
IL
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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