Individual
TERESA LYNNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
118 N SUMMIT ST, ARKANSAS CITY, KS 67005-2258
(620) 506-5005
(620) 506-5002
Mailing address
118 N SUMMIT ST, ARKANSAS CITY, KS 67005-2258
(620) 660-2105
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5377626021
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5377626021
FNP NUMBER
KS
Enumeration date
05/03/2017
Last updated
10/04/2023
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