Individual
ANNESIA KATRINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1950 LEE RD STE 104, WINTER PARK, FL 32789-1847
(407) 956-1870
(407) 641-8178
Mailing address
1950 LEE RD STE 104, WINTER PARK, FL 32789-1847
(407) 956-1870
(407) 641-8178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9500989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN9500989
FLORIDA NURSING LICENSE
FL
Enumeration date
04/25/2019
Last updated
04/25/2019
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