Individual
MICHELLE MAGGI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10571 TELEGRAPH RD STE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 261-4935
Mailing address
10571 TELEGRAPH RD STE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 261-4935
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024179601
VA
Other
Enumeration date
07/24/2020
Last updated
07/25/2023
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