Individual
KERI D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-2397
Mailing address
14413 GRANT ST, OVERLAND PARK, KS 66221-2521
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021004379
MO
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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