Individual
MS. CARMEN B. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1530 ROUTE 9, WAPPINGERS FALLS, NY 12590-4131
(845) 297-2511
Mailing address
15 REGENT DR, HOPEWELL JUNCTION, NY 12533-5503
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
332370
NY
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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