Individual
PAMELA A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
977 WINDY LOU CT APT 4, MEMPHIS, TN 38116-6352
(501) 747-4975
Mailing address
977 WINDY LOU CT APT 4, MEMPHIS, TN 38116-6352
(501) 747-4975
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
110706669
TN
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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