Individual
TRACY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1487 W KEISER AVE, OSCEOLA, AR 72370-2806
(870) 622-0592
(870) 622-0782
Mailing address
4508 STADIUM BLVD, JONESBORO, AR 72404-9675
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R44657
AR
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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