Individual
SHELBY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
17065 US 71, BELTON, MO 64012
(816) 348-1250
Mailing address
1103 CAMELOT DR, RAYMORE, MO 64083-8313
(816) 559-1658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2015011981
MO
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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