Individual
MRS. CRYSTAL LOUISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, WHNP-BC
Contact information
Practice address
2700 PGA BLVD STE 103, PALM BEACH GARDENS, FL 33410-2958
(561) 630-8001
Mailing address
2322 SAINT LUCIE BLVD, FORT PIERCE, FL 34946-6722
(772) 240-3159
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9437936
FL
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN11037866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11037866
APRN
FL
01
—
RN9437936
RN
FL
Enumeration date
05/19/2017
Last updated
02/21/2025
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