Individual
BRANDI FAYE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
3913 DOVE LN, TEMPLE, TX 76502-2435
(210) 867-1985
Mailing address
3913 DOVE LN, TEMPLE, TX 76502-2435
(210) 867-1985
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
1178423
TX
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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