Individual
MISS KATHERINE ANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1100 W 39TH 1/2 ST, AUSTIN, TX 78756-3902
(512) 454-4545
Mailing address
1100 W 39TH 1/2 ST, AUSTIN, TX 78756-3902
(512) 454-4545
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
781377
TX
Other
Enumeration date
04/10/2013
Last updated
03/17/2014
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