Individual
TERI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1860 WATSON BLVD, WARNER ROBINS, GA 31093-3612
(478) 225-9001
Mailing address
1860 WATSON BLVD, WARNER ROBINS, GA 31093-3612
(478) 225-9001
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN190639
GA
Other
Enumeration date
02/04/2015
Last updated
08/02/2019
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