Individual
MRS. ALICE MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2690 MADISON ST, SUITE 130, CLARKSVILLE, TN 37043-5975
(931) 245-1701
(931) 245-1720
Mailing address
2690 MADISON ST, SUITE 130, CLARKSVILLE, TN 37043-5975
(931) 245-1701
(931) 245-1720
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000015967
TN
Other
Enumeration date
08/04/2011
Last updated
11/04/2014
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