Individual
JACKSON SON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5039 AMERICANA DR, ANNANDALE, VA 22003-5068
(571) 524-0881
Mailing address
5039 AMERICANA DR, ANNANDALE, VA 22003-5068
(571) 524-0881
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024189383
VA
Other
Enumeration date
03/13/2024
Last updated
11/19/2025
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