Individual
MARILYN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6225 N STATE HIGHWAY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
(972) 518-2100
Mailing address
6670 SHAPIRO CT, STONE MOUNTAIN, GA 30087-4677
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1008621
TX
367500000X
Certified Registered Nurse Anesthetist
RN240925
GA
Other
Enumeration date
04/22/2020
Last updated
01/21/2026
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