Individual
CATHERINE ALISA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 298-4331
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 298-4331
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.0034084
OH
Other
Enumeration date
06/19/2023
Last updated
01/25/2024
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