Individual
ALNITA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
114 TIMBERIDGE DR, RAEFORD, NC 28376-5640
(910) 709-3042
Mailing address
114 TIMBERIDGE DR, RAEFORD, NC 28376-5640
(910) 709-3042
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
5009383
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5009383
NURSE PRACTITONER
NC
Enumeration date
03/29/2017
Last updated
03/29/2017
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