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Individual

JONATHAN D JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
25 TRANQUIL LN, RINGGOLD, GA 30736-2859
(423) 902-9979
(423) 373-1228
Mailing address
25 TRANQUIL LN, RINGGOLD, GA 30736-2859
(423) 902-9979

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN162421
GA

Other

Enumeration date
08/02/2022
Last updated
08/02/2022
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