Individual
POET LATIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
98 S RIVER DR UNIT 4030, TEMPE, AZ 85288-0059
(815) 908-8969
Mailing address
98 S RIVER DR UNIT 4030, TEMPE, AZ 85288-0059
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
329264
AZ
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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