Individual
ANDREA DELOIS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1114 W 6TH ST, HANFORD, CA 93230-4901
(559) 582-0397
Mailing address
1114 W 6TH ST, HANFORD, CA 93230-4901
(559) 582-0397
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP95012994
CA
Other
Enumeration date
09/05/2019
Last updated
10/16/2019
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