Individual
NICOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1850 STATE ST, PHARMACY, NEW ALBANY, IN 47150-4990
(812) 948-7404
Mailing address
1850 STATE ST, PHARMACY, NEW ALBANY, IN 47150-4990
(812) 948-7404
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67004988A
IN
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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