Individual
CARMEN YOLANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 287-2555
Mailing address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 287-2555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN149316
GA
Other
Enumeration date
07/11/2017
Last updated
07/21/2022
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