Individual
BEVERLY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2065 HERSCHEL ST, JACKSONVILLE, FL 32204-3817
(904) 387-4050
(904) 387-4860
Mailing address
2065 HERSCHEL ST, JACKSONVILLE, FL 32204-3817
(904) 387-4050
(904) 387-4860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN9240628
FL
Other
Enumeration date
02/23/2007
Last updated
10/15/2008
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