Individual
ALISA MCCALL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3290 SIXES RD, CANTON, GA 30114-9102
(678) 374-7514
Mailing address
3333 RIVERWOOD PKWY SE STE 250, ATLANTA, GA 30339-3304
(770) 914-0116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F08200861
GA
Other
Enumeration date
09/09/2020
Last updated
08/15/2024
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