Individual
PHARRODAH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7008 LITTLE RIVER TPKE STE G, ANNANDALE, VA 22003-3234
(833) 357-0704
Mailing address
5113 SOUTHERN AVE APT 101, CAPITOL HEIGHTS, MD 20743-5170
(240) 714-8758
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002098056
VA
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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