Individual
KATHY LACOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
151 E WOOD ST, SPARTANBURG, SC 29303-3016
(864) 596-3337
Mailing address
151 E WOOD ST, SPARTANBURG, SC 29303-3016
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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