Individual
CHIQUITA MICHONE THOMAS-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3916 S CRATER RD, PETERSBURG, VA 23805-9202
(804) 526-4300
Mailing address
307 S 17TH AVE, HOPEWELL, VA 23860-3609
(757) 678-6682
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024178799
VA
Other
Enumeration date
06/29/2021
Last updated
06/30/2021
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