Individual
MS. LISA MACHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2137
(928) 669-3131
Mailing address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2137
(928) 669-3131
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
673042
TX
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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