Individual
LAURAINE M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3212 N WINDSONG DR, SUITE 200, PRESCOTT VALLEY, AZ 86314-2255
(928) 583-1000
(866) 751-4157
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7782
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN098038
AZ
Other
Enumeration date
11/15/2012
Last updated
06/07/2017
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