Individual
SANDRA PAOLA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
10 MOTT AVE STE 2A, NORWALK, CT 06850-3320
(203) 855-7551
Mailing address
10 MOTT AVE STE 2A, NORWALK, CT 06850-3320
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
12560
CT
Other
Enumeration date
12/19/2023
Last updated
12/20/2023
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