Individual
MARITA CECILIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
327 S JUPITER RD APT 924, ALLEN, TX 75002-3074
(619) 416-5775
Mailing address
327 S JUPITER RD APT 924, ALLEN, TX 75002-3074
(619) 416-5775
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
185680
CA
164X00000X
Licensed Vocational Nurse
Primary
338145
TX
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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