Individual
ALICE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN NP
Contact information
Practice address
6121 N THESTA, SUITE 303, FRESNO, CA 93710-5294
(559) 228-5448
(559) 224-3920
Mailing address
PO BOX 28947, FRESNO, CA 93729-8947
(559) 228-5448
(559) 224-3920
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
358153
CA
Other
Enumeration date
07/19/2006
Last updated
12/14/2007
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